Provider Demographics
NPI:1255193355
Name:WHITE, JUDY ANN (DMIN & DPC)
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:ANN
Last Name:WHITE
Suffix:
Gender:F
Credentials:DMIN & DPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BAYBERRY DRIVE, #3
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067
Mailing Address - Country:US
Mailing Address - Phone:617-869-0185
Mailing Address - Fax:
Practice Address - Street 1:4 BAYBERRY DRIVE
Practice Address - Street 2:UNIT 3
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067
Practice Address - Country:US
Practice Address - Phone:781-989-2372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral