Provider Demographics
NPI:1003467671
Name:BENBOW, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BENBOW
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 1:31 PARKER ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1214
Mailing Address - Country:US
Mailing Address - Phone:781-249-3338
Mailing Address - Fax:
Practice Address - Street 1:31 PARKER ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1214
Practice Address - Country:US
Practice Address - Phone:781-249-3338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker