Provider Demographics
NPI:1790112928
Name:HAND, JUDY
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:HAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SE 3RD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4036
Mailing Address - Country:US
Mailing Address - Phone:503-597-3886
Mailing Address - Fax:
Practice Address - Street 1:111 SE 3RD AVE STE B
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4036
Practice Address - Country:US
Practice Address - Phone:503-597-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health