Provider Demographics
NPI:1245560374
Name:CHURACH, JUDITH ANN (MS)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:CHURACH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2173 EMBASSY DR
Mailing Address - Street 2:SUITE 255
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2387
Mailing Address - Country:US
Mailing Address - Phone:717-431-2027
Mailing Address - Fax:
Practice Address - Street 1:2173 EMBASSY DR
Practice Address - Street 2:SUITE 255
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2387
Practice Address - Country:US
Practice Address - Phone:717-431-2027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health