Provider Demographics
NPI:1225277486
Name:SIMON, JULIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CENTRAL AVE
Mailing Address - Street 2:P. O. BOX 6386
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-2243
Mailing Address - Country:US
Mailing Address - Phone:518-458-8183
Mailing Address - Fax:518-458-8184
Practice Address - Street 1:400 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-2243
Practice Address - Country:US
Practice Address - Phone:518-458-8183
Practice Address - Fax:518-458-8184
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist