Provider Demographics
NPI:1790733178
Name:NEIGHBOURS, JUDITH SIMPSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:SIMPSON
Last Name:NEIGHBOURS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E COLORADO BLVD
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-2795
Mailing Address - Country:US
Mailing Address - Phone:605-642-5030
Mailing Address - Fax:605-722-0028
Practice Address - Street 1:125 E COLORADO BLVD
Practice Address - Street 2:SUITE 2D
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-2795
Practice Address - Country:US
Practice Address - Phone:605-642-5030
Practice Address - Fax:605-722-0028
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD321103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6550883Medicaid
SD4157OtherBLUE CROSS
SD6550883Medicaid