Organization
A CENTER 4 CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONYA MICHELLE JUDD MS (CO OWNER)
(606) 393-5586
Entity
Organization
Contact information
Practice address
5900 US 60 W, SUITE B, ASHLAND, KY 41101
(606) 393-5586
Mailing address
PO BOX 5074, ASHLAND, KY 41105-5074
(606) 393-5586
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
0138351016
KY
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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