Provider Demographics
NPI:1710291208
Name:MCNEILSMITH, JUDY
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:MCNEILSMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-3141
Mailing Address - Country:US
Mailing Address - Phone:719-587-0538
Mailing Address - Fax:719-587-0388
Practice Address - Street 1:911 STATE AVE
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-3141
Practice Address - Country:US
Practice Address - Phone:719-587-0538
Practice Address - Fax:719-587-0388
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional