Healthcare Provider Details

I. General information

NPI: 1780802835
Provider Name (Legal Business Name): JUDITH A COX M.A.,L.L.P.C.,N.C.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JUDITH A COX-WENTZ

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 CARPENTER DR
PONTIAC MI
48340-3313
US

IV. Provider business mailing address

1116 CARPENTER DR
PONTIAC MI
48340-3313
US

V. Phone/Fax

Practice location:
  • Phone: 248-396-9537
  • Fax:
Mailing address:
  • Phone: 248-396-9537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401009497
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: