Provider Demographics
NPI:1285641456
Name:BROWN, JUDY STOKER (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:STOKER
Last Name:BROWN
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 1:6206 BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-3030
Mailing Address - Country:US
Mailing Address - Phone:703-368-1553
Mailing Address - Fax:703-368-1553
Practice Address - Street 1:214 COMMERCE STREET
Practice Address - Street 2:B
Practice Address - City:OCCOQUAN
Practice Address - State:VA
Practice Address - Zip Code:22125-0063
Practice Address - Country:US
Practice Address - Phone:703-494-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001056103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical