Individual
JUDITH CLABAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2032 NEW CASTLE AVE, NEW CASTLE, DE 19720-7703
(302) 654-1700
(302) 654-9474
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J10000853
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000037754
—
DE
01
—
174601390
CHAMPUS
—
01
—
2099536000
IBC AMERIHEALTH
—
01
—
5070-0004
CAREFIRST
—
01
—
618092101
CAREFIRST
—
Enumeration date
06/11/2006
Last updated
12/22/2017
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