Provider Demographics
NPI:1104093806
Name:ISRAEL, JUDITH TOBY (APRN BC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:TOBY
Last Name:ISRAEL
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Gender:F
Credentials:APRN BC
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Mailing Address - Street 1:234 COPELAND ST FL 3
Mailing Address - Street 2:MASS BAY COUNSELING
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4005
Mailing Address - Country:US
Mailing Address - Phone:617-786-0137
Mailing Address - Fax:617-479-4798
Practice Address - Street 1:234 COPELAND ST FL 3
Practice Address - Street 2:MASS BAY COUNSELING
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4005
Practice Address - Country:US
Practice Address - Phone:617-786-0137
Practice Address - Fax:617-479-4798
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-11-20
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Provider Licenses
StateLicense IDTaxonomies
MA130812364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health