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General NPI Number Information
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NPI Number | 1134336746
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Entity Type | Individual
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Provider Name | JUDITH EVANS CLAIR L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 9024 FLETCHERS MILL RD
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City | MARSHALL
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State | VA
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Zip | 20115-2035
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Country | US
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Telephone | 540-341-7397
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Fax |
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Provider Business Mailing Address
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Address Line | 9024 FLETCHERS MILL RD
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City | MARSHALL
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State | VA
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Zip | 20115-2035
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Country | US
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Telephone | 540-341-7397
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701001273
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License Number State | VA
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