Provider Demographics
NPI:1083392450
Name:ELDEAN, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:ELDEAN
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 1:469 CENTERVILLE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4356
Mailing Address - Country:US
Mailing Address - Phone:401-773-3700
Mailing Address - Fax:401-773-3701
Practice Address - Street 1:469 CENTERVILLE RD STE 105
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4356
Practice Address - Country:US
Practice Address - Phone:401-773-3700
Practice Address - Fax:401-773-3701
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health