MEDICARE: MS. MARY E JUDD-PECHIE LICSW

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	1041C0700X	Clinical Social Worker	005057	MA

General Provider Information

NPI Number	:	1487649117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY E JUDD-PECHIE LICSW

Provider Business Mailing Address
First Line	:	340 THOMPSON RD
Second Line	:
City	:	WEBSTER
State	:	MA
Zip	:	01570-1509
Country	:	US
Telephone Number	:	508-949-8948
Fax Number	:	508-764-2462

Provider Business Practice Location Address
First Line	:	340 THOMPSON RD
Second Line	:
City	:	WEBSTER
State	:	MA
Zip	:	01570-1509
Country	:	US
Telephone Number	:	508-949-8948
Fax Number	:

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	04/24/2024

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