Provider Demographics
NPI:1417199308
Name:SHEW, JUDITH SHARON (MC)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:SHARON
Last Name:SHEW
Suffix:
Gender:F
Credentials:MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 E UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-7855
Mailing Address - Country:US
Mailing Address - Phone:520-870-7939
Mailing Address - Fax:520-628-1407
Practice Address - Street 1:616 E UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7855
Practice Address - Country:US
Practice Address - Phone:520-870-7939
Practice Address - Fax:520-628-1407
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-1787101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional