Individual
DR. JUDITH G TUDIVER
Active
Individual
DR. JUDITH G TUDIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
P0000002479
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010300860
—
VA
01
—
229346
COMPSYCH
TN
05
—
3982954
—
TN
01
—
4065358
BS PIN-UNAKA ADDRESS
TN
01
—
540270000
MAGELLAN MIS
TN
01
—
7270161
AETNA PIN
TN
Enumeration date
05/24/2005
Last updated
07/09/2007
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