Provider Demographics
NPI:1225672744
Name:DRAKE, JULIE RUTH (BSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RUTH
Last Name:DRAKE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 AUSTIN BLUFFS PARKWAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918
Mailing Address - Country:US
Mailing Address - Phone:719-225-6264
Mailing Address - Fax:719-368-7678
Practice Address - Street 1:2406 CLIFFMOOR LN
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2351
Practice Address - Country:US
Practice Address - Phone:719-225-6264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker