Provider Demographics
NPI:1043569098
Name:JUDGE, ANN B (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:B
Last Name:JUDGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 OLD SOLOMONS ISLAND RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3854
Mailing Address - Country:US
Mailing Address - Phone:410-266-8555
Mailing Address - Fax:410-266-5328
Practice Address - Street 1:49 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3854
Practice Address - Country:US
Practice Address - Phone:410-266-8555
Practice Address - Fax:410-266-5328
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03540103TC1900X
DCPSY 1000018103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling