Derriso, Judith Loudon

Derriso, Judith Loudon is an individual health care provider with primary practice located at 308 Coliseum Dr Suite 120, Macon GA 31217-3865. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Derriso, Judith Loudon can be contacted via phone (478) 745-6130.

Contact Information

Primary practice address
308 Coliseum Dr Suite 120 Macon GA 31217-3865
Fax: (478) 745-4443
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 426 Georgia

Profile Details

NPI number 1437148426
LBN Legal business name Derriso, Judith Loudon
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Feb 11th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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