Provider Demographics
NPI:1679622203
Name:PILLA, JUDITH MARGARET (PHD, LSW)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:MARGARET
Last Name:PILLA
Suffix:
Gender:F
Credentials:PHD, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HUGHES RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3711
Mailing Address - Country:US
Mailing Address - Phone:610-687-8608
Mailing Address - Fax:610-688-1928
Practice Address - Street 1:203 HUGHES RD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3711
Practice Address - Country:US
Practice Address - Phone:610-687-8608
Practice Address - Fax:610-688-1928
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW005548E1041C0700X
PARN212657L364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult