Provider Demographics
NPI:1619054756
Name:WEINSTEIN, JUDITH A (MA, LICACUP, L/OTR)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:A
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:MA, LICACUP, L/OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1371
Mailing Address - Country:US
Mailing Address - Phone:978-443-6789
Mailing Address - Fax:978-440-8339
Practice Address - Street 1:75 UNION AVE STE 101
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-2255
Practice Address - Country:US
Practice Address - Phone:978-443-6789
Practice Address - Fax:978-440-8339
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0241171100000X
MA1178225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist