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NPI Code Detail

MEDICARE: NINA ALEXANDRA JUDD LPC

MEDICARE: NINA ALEXANDRA JUDD LPC
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
1101YP2500XProfessional CounselorPC014745PA

General Provider Information

NPI Number : 1790408649
Entity Type Code : Individual
Provider Name (Legal Business Name) : NINA ALEXANDRA JUDD LPC
Provider Business Mailing Address
First Line : 845 CHURCH RD
Second Line :
City : HARLEYSVILLE
State : PA
Zip : 19438-2852
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1420 WALNUT ST STE 802
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-4008
Country : US
Telephone Number : 610-544-2110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2022
Last Update Date : 09/26/2022

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Directions to “ NINA ALEXANDRA JUDD LPC” Practice Location

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