MEDICARE: LAUREN M. JUDD SSW

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	104100000X	Social Worker	7202183-3503	UT

General Provider Information

NPI Number	:	1992370126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN M. JUDD SSW

Provider Business Mailing Address
First Line	:	PO BOX 55
Second Line	:
City	:	WALTON
State	:	KY
Zip	:	41094-0055
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 W 7200 S STE 100
Second Line	:
City	:	MIDVALE
State	:	UT
Zip	:	84047-1014
Country	:	US
Telephone Number	:	844-584-7284
Fax Number	:

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

Provider Enumeration Date	:	05/20/2021
Last Update Date	:	05/20/2021

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Directions to “ LAUREN M. JUDD SSW” Practice Location

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