Provider Demographics
NPI:1528229408
Name:KUO, JUDY I (MT-BC, LPC)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:I
Last Name:KUO
Suffix:
Gender:F
Credentials:MT-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 KNIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-4242
Mailing Address - Country:US
Mailing Address - Phone:215-637-2077
Mailing Address - Fax:215-637-2079
Practice Address - Street 1:10700 KNIGHTS RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-4242
Practice Address - Country:US
Practice Address - Phone:215-637-2077
Practice Address - Fax:215-637-2079
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC003623OtherPA BUREAU OF PROFESSIONAL & OCCUPATIONAL AFFAIRS