Provider Demographics
NPI:1205032505
Name:POPE WARD, JUDITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:POPE WARD
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 1:925 REVOLUTION MILL DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5178
Mailing Address - Country:US
Mailing Address - Phone:336-334-5773
Mailing Address - Fax:336-334-5811
Practice Address - Street 1:925 REVOLUTION MILL DR
Practice Address - Street 2:SUITE 7
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5178
Practice Address - Country:US
Practice Address - Phone:336-334-5773
Practice Address - Fax:336-334-5811
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-23
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1758103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist