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General NPI Number Information
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NPI Number | 1497816516
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Entity Type | Individual
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Provider Name | JUDITH JEAN CRITES-LUTZ L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 398 STATE HWY BB
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City | HOLLISTER
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State | MO
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Zip | 65673-0960
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Country | US
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Telephone | 417-334-2502
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Fax | 417-334-6203
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Provider Business Mailing Address
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Address Line | PO BOX 1389 16209 US HWY 160
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City | FORSYTH
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State | MO
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Zip | 65653-1389
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Country | US
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Telephone | 417-546-6003
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Fax | 417-546-6005
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 001802
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License Number State | MO
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