Provider Demographics
NPI:1114908886
Name:CAIN-OLIVER, JUDITH L (DR)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:L
Last Name:CAIN-OLIVER
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 PLAINVIEW CENTER
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139
Mailing Address - Country:US
Mailing Address - Phone:804-598-9577
Mailing Address - Fax:804-598-0084
Practice Address - Street 1:2156 PLAINVIEW CENTER
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139
Practice Address - Country:US
Practice Address - Phone:804-598-9577
Practice Address - Fax:804-598-0084
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000169103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical