MEDICARE: DR. JUDITH L CAIN-OLIVER DR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810000169	VA

General Provider Information

NPI Number	:	1114908886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH L CAIN-OLIVER DR.

Provider Business Mailing Address
First Line	:	2156 PLAINVIEW CENTER
Second Line	:
City	:	POWHATAN
State	:	VA
Zip	:	23139
Country	:	US
Telephone Number	:	804-598-9577
Fax Number	:	804-598-0084

Provider Business Practice Location Address
First Line	:	2156 PLAINVIEW CENTER
Second Line	:
City	:	POWHATAN
State	:	VA
Zip	:	23139
Country	:	US
Telephone Number	:	804-598-9577
Fax Number	:	804-598-0084

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	08/04/2008

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