Provider Demographics
NPI:1598829368
Name:LANDVOY, JUDITH ANN (MA)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ANN
Last Name:LANDVOY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 S 2ND ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-2632
Mailing Address - Country:US
Mailing Address - Phone:509-965-2494
Mailing Address - Fax:
Practice Address - Street 1:6 S 2ND ST
Practice Address - Street 2:SUITE 307
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2632
Practice Address - Country:US
Practice Address - Phone:509-965-2494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health