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General NPI Number Information
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NPI Number | 1851591556
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Entity Type | Individual
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Provider Name | JUDITH ANN KUNTZ MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 07/20/2007
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Provider Practice Location Address
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Address Line | 8855 SW HOLLY LANE SUITE 106
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City | WILSONVILLE
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State | OR
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Zip | 97070
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Country | US
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Telephone | 503-481-8943
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Fax | 503-925-1897
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Provider Business Mailing Address
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Address Line | PO B0X 563
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City | WILSONVILLE
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State | OR
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Zip | 97070
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Country | US
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Telephone | 503-841-8943
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Fax | 503-925-1897
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T0453
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License Number State | OR
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