Provider Demographics
NPI:1962563197
Name:JUDD, CATHARINE WHITEHOUSE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CATHARINE
Middle Name:WHITEHOUSE
Last Name:JUDD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:912 KILLIAN HILL ROAD SW
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047
Mailing Address - Country:US
Mailing Address - Phone:770-638-7200
Mailing Address - Fax:770-638-7265
Practice Address - Street 1:912 KILLIAN HILL RD SW
Practice Address - Street 2:SUITE 103
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3138
Practice Address - Country:US
Practice Address - Phone:770-638-7200
Practice Address - Fax:770-638-7265
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GASLP000574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52172949001OtherBLUE CROSS BLUE SHIELD
GA331765OtherWELLCARE HEALTH PLANS
GA10054036OtherAMERIGROUP CORPORATION
GA7571771OtherAETNA