MEDICARE: MS. JUDY A RICHARDSON MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	E0000316	OH

General Provider Information

NPI Number	:	1629180047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDY A RICHARDSON MS

Provider Business Mailing Address
First Line	:	6500 CRESTRIDGE CIR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45213-1052
Country	:	US
Telephone Number	:	513-351-3428
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 WELLINGTON PL
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-1710
Country	:	US
Telephone Number	:	513-721-1500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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