Provider Demographics
NPI:1124273347
Name:STONE, JUDITH TAMAR (MA PSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:TAMAR
Last Name:STONE
Suffix:
Gender:F
Credentials:MA PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 A 30TH STREET
Mailing Address - Street 2:SUITE 373
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:303-494-5849
Mailing Address - Fax:
Practice Address - Street 1:2950 N LAKERIDGE TRL
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-9310
Practice Address - Country:US
Practice Address - Phone:303-494-5849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor