Provider Demographics
NPI:1003138090
Name:SIMON, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:SIMON
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:PO BOX 89
Mailing Address - Street 2:
Mailing Address - City:ALLAKAKET
Mailing Address - State:AK
Mailing Address - Zip Code:99720-0089
Mailing Address - Country:US
Mailing Address - Phone:907-968-2210
Mailing Address - Fax:907-968-2288
Practice Address - Street 1:2ND STREET
Practice Address - Street 2:
Practice Address - City:ALLAKAKET
Practice Address - State:AK
Practice Address - Zip Code:99720-0089
Practice Address - Country:US
Practice Address - Phone:907-968-2210
Practice Address - Fax:907-968-2288
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor