Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 103TS0200X | School Psychologist |
NPI | 1023347283 |
---|---|
Provider Name | Judy K Maxwell |
First Address | Audubon, PA 19403-5263 |
Second Address | Audubon, PA 19403-5263 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2009 |
Last Update Date | 17/12/2009 |