Provider Demographics
NPI:1265505325
Name:STERNAL, JUDITH ANNETTE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANNETTE
Last Name:STERNAL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:ANNETTE
Other - Last Name:WOODWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:63 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER FOXCROFT
Mailing Address - State:ME
Mailing Address - Zip Code:04426-1135
Mailing Address - Country:US
Mailing Address - Phone:207-564-6535
Mailing Address - Fax:207-564-6531
Practice Address - Street 1:63 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:DOVER FOXCROFT
Practice Address - State:ME
Practice Address - Zip Code:04426-1135
Practice Address - Country:US
Practice Address - Phone:207-564-6535
Practice Address - Fax:207-564-6531
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist