Individual
JUDITH JUHALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, HSPP
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5413
Mailing address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5413
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041019
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200114720
—
IN
Enumeration date
05/04/2006
Last updated
04/29/2013
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