Provider Demographics
NPI:1588711733
Name:OKAWA, JUDY B (PHD)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:B
Last Name:OKAWA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9806 LORD CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2803
Mailing Address - Country:US
Mailing Address - Phone:703-425-7273
Mailing Address - Fax:202-544-5177
Practice Address - Street 1:1308 CONSTITUTION AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-6420
Practice Address - Country:US
Practice Address - Phone:202-544-6060
Practice Address - Fax:202-544-5177
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY 1000274103T00000X
VA0810002508103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist