Provider Demographics
NPI:1083389845
Name:STREICH, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:STREICH
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 1:4800 HANALEI PLANTATION RD APT 5B
Mailing Address - Street 2:
Mailing Address - City:PRINCEVILLE
Mailing Address - State:HI
Mailing Address - Zip Code:96722-5465
Mailing Address - Country:US
Mailing Address - Phone:312-515-8897
Mailing Address - Fax:
Practice Address - Street 1:4800 HANALEI PLANTATION RD APT 5B
Practice Address - Street 2:
Practice Address - City:PRINCEVILLE
Practice Address - State:HI
Practice Address - Zip Code:96722-5465
Practice Address - Country:US
Practice Address - Phone:312-515-8897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBACB698148106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician