Provider Demographics
NPI:1043925183
Name:CADDELL, JULIA (BSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:CADDELL
Suffix:
Gender:F
Credentials:BSW
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 1272
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03866-1272
Mailing Address - Country:US
Mailing Address - Phone:603-841-5353
Mailing Address - Fax:603-841-5355
Practice Address - Street 1:326 ROCHESTER HILL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1700
Practice Address - Country:US
Practice Address - Phone:603-841-5353
Practice Address - Fax:603-841-5355
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator