Provider Demographics
NPI:1821458779
Name:MARSH, JUDY MAI (MFT)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:MAI
Last Name:MARSH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10939
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-5939
Mailing Address - Country:US
Mailing Address - Phone:808-238-8164
Mailing Address - Fax:
Practice Address - Street 1:190 KEAWE ST STE 33
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2849
Practice Address - Country:US
Practice Address - Phone:808-238-8164
Practice Address - Fax:808-969-1070
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI459106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist