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General NPI Number Information
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NPI Number | 1285641456
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Entity Type | Individual
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Provider Name | JUDY STOKER BROWN PHD
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 214 COMMERCE STREET B
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City | OCCOQUAN
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State | VA
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Zip | 22125-0063
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Country | US
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Telephone | 703-494-6830
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Fax |
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Provider Business Mailing Address
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Address Line | 6206 BLOSSOM LN
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City | MANASSAS
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State | VA
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Zip | 20112-3030
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Country | US
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Telephone | 703-368-1553
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Fax | 703-368-1553
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810001056
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License Number State | VA
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