Provider Demographics
NPI:1831390327
Name:KREPSKY, JUDITH CAROL (PHD)
Entity type:Individual
Prefix:PROF
First Name:JUDITH
Middle Name:CAROL
Last Name:KREPSKY
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 1:2618 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-6352
Mailing Address - Country:US
Mailing Address - Phone:920-452-0909
Mailing Address - Fax:920-452-0907
Practice Address - Street 1:2618 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-6352
Practice Address - Country:US
Practice Address - Phone:920-452-0909
Practice Address - Fax:920-452-0907
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2904-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist