Provider Demographics
NPI:1073962148
Name:JULIE M LESPERANCE, PSY.D., PLLC
Entity Type:Organization
Organization Name:JULIE M LESPERANCE, PSY.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LESPERANCE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:480-550-1776
Mailing Address - Street 1:PO BOX 3742
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85271-3742
Mailing Address - Country:US
Mailing Address - Phone:480-550-1776
Mailing Address - Fax:
Practice Address - Street 1:3013 N 67TH PL STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6169
Practice Address - Country:US
Practice Address - Phone:480-550-1776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4629103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty