Provider Demographics
NPI:1093413122
Name:BACH, JULIE (NBHWC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:BACH
Suffix:
Gender:F
Credentials:NBHWC
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 4911
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631-4911
Mailing Address - Country:US
Mailing Address - Phone:970-376-6220
Mailing Address - Fax:
Practice Address - Street 1:55B GAMBEL ST
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-5957
Practice Address - Country:US
Practice Address - Phone:970-376-6220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-3632605171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach