Provider Demographics
NPI:1730146432
Name:TOOR, JUDITH A (MSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:TOOR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 N MAYFAIR RD STE 219
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1404
Mailing Address - Country:US
Mailing Address - Phone:414-256-0075
Mailing Address - Fax:
Practice Address - Street 1:2505 N MAYFAIR RD STE 219
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1404
Practice Address - Country:US
Practice Address - Phone:414-256-0075
Practice Address - Fax:414-256-0070
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
003700486Medicare ID - Type Unspecified
000101414Medicare PIN
P73904Medicare UPIN