Provider Demographics
NPI:1750593315
Name:BOARDMAN, JUDITH BALDWIN (PHD, RNCS)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:BALDWIN
Last Name:BOARDMAN
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Gender:F
Credentials:PHD, RNCS
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Mailing Address - Street 1:162 FEDERAL ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3248
Mailing Address - Country:US
Mailing Address - Phone:888-682-2224
Mailing Address - Fax:978-745-4307
Practice Address - Street 1:162 FEDERAL ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3248
Practice Address - Country:US
Practice Address - Phone:888-682-2224
Practice Address - Fax:978-745-4307
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA131301364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult