Provider Demographics
NPI:1457497521
Name:STUBBS, JUDITH R (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:R
Last Name:STUBBS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9116 KENLOCK DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242-3328
Mailing Address - Country:US
Mailing Address - Phone:502-423-0010
Mailing Address - Fax:502-423-0010
Practice Address - Street 1:9116 KENLOCK DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40242-3328
Practice Address - Country:US
Practice Address - Phone:502-423-0010
Practice Address - Fax:502-423-0010
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0533106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist