Provider Demographics
NPI:1154508901
Name:PARKER, JULIE L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:L
Last Name:PARKER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:L
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:221 N CAUSEWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169-5298
Mailing Address - Country:US
Mailing Address - Phone:386-423-0442
Mailing Address - Fax:386-423-0402
Practice Address - Street 1:221 N CAUSEWAY
Practice Address - Street 2:SUITE B
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32169-5298
Practice Address - Country:US
Practice Address - Phone:386-423-0442
Practice Address - Fax:386-423-0402
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7533103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist