Provider Demographics
NPI:1073886768
Name:GREEN, JULIE MARTIN (MT-BC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARTIN
Last Name:GREEN
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:CHRISTINE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:403 GIBBS RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-3109
Mailing Address - Country:US
Mailing Address - Phone:727-504-1927
Mailing Address - Fax:
Practice Address - Street 1:403 GIBBS RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-3109
Practice Address - Country:US
Practice Address - Phone:727-504-1927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-11
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist