1528229408 NPI number — MS. JUDY I KUO MT-BC, LPC

Table of content: MS. JUDY I KUO MT-BC, LPC (NPI 1528229408)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528229408 NPI number — MS. JUDY I KUO MT-BC, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUO
Provider First Name:
JUDY
Provider Middle Name:
I
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MT-BC, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528229408
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10700 KNIGHTS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19114-4242
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-637-2077
Provider Business Mailing Address Fax Number:
215-637-2079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10700 KNIGHTS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19114-4242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-637-2077
Provider Business Practice Location Address Fax Number:
215-637-2079
Provider Enumeration Date:
06/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PC003623 . This is a "PA BUREAU OF PROFESSIONAL & OCCUPATIONAL AFFAIRS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com