Provider Demographics
NPI:1093768566
Name:COOK, JUDITH WALMSLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:WALMSLEY
Last Name:COOK
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 1:180 PROVIDENCE RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2206
Mailing Address - Country:US
Mailing Address - Phone:919-493-2219
Mailing Address - Fax:919-493-2219
Practice Address - Street 1:180 PROVIDENCE RD
Practice Address - Street 2:SUITE 7
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2206
Practice Address - Country:US
Practice Address - Phone:919-493-2219
Practice Address - Fax:919-493-2219
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC797103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2492772AMedicare ID - Type Unspecified