Provider Demographics
NPI:1134333651
Name:NAGINEY, JUDITH LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:LYNN
Last Name:NAGINEY
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 1:352 INDIAN PAINTBRUSH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-5378
Mailing Address - Country:US
Mailing Address - Phone:307-265-3287
Mailing Address - Fax:
Practice Address - Street 1:940 E 3RD ST
Practice Address - Street 2:SUITE 212
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3237
Practice Address - Country:US
Practice Address - Phone:307-577-3050
Practice Address - Fax:307-577-4296
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY380103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist