Provider Demographics
NPI:1992889315
Name:FLOWER, JUDITH CHOATE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:CHOATE
Last Name:FLOWER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 178
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:VT
Mailing Address - Zip Code:05343
Mailing Address - Country:US
Mailing Address - Phone:802-874-4837
Mailing Address - Fax:802-874-4774
Practice Address - Street 1:1905 TURKEY MTN ROAD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:VT
Practice Address - Zip Code:05343
Practice Address - Country:US
Practice Address - Phone:802-874-4837
Practice Address - Fax:802-874-4774
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0480000425103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1002424Medicaid
T00935OtherTRICARE
NH30421755Medicaid
VT1002424Medicaid