Tudiver, Judith G

Tudiver, Judith G is an sole proprietor health care provider with primary practice located at 415 E Unaka Ave , Johnson City TN 37601-4030. She recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as her primary health care specialty. Tudiver, Judith G can be contacted via phone (423) 341-4752.

Contact Information

Primary practice address
415 E Unaka Ave Johnson City TN 37601-4030
Phone: (423) 341-4752
Fax: (423) 283-0931
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X P0000002479 Tennessee

Profile Details

NPI number 1316940182
LBN Legal business name Tudiver, Judith G
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316940182 NPPES
Tennessee Other 540270000 MAGELLAN MIS
Tennessee Other 229346 MAGELLAN MIS
Tennessee Other 4065358 MAGELLAN MIS
Tennessee MEDICAID 3982954 MAGELLAN MIS
Tennessee Other 4065358 MAGELLAN MIS
Tennessee Other 7270161 MAGELLAN MIS
Tennessee MEDICAID 010300860 MAGELLAN MIS

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