Provider Demographics
NPI:1275091704
Name:STRATHMAN, JULIE ROSE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ROSE
Last Name:STRATHMAN
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 1:1415 MORTON ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68355-2759
Mailing Address - Country:US
Mailing Address - Phone:402-245-2825
Mailing Address - Fax:402-245-2022
Practice Address - Street 1:1415 MORTON ST
Practice Address - Street 2:
Practice Address - City:FALLS CITY
Practice Address - State:NE
Practice Address - Zip Code:68355-2759
Practice Address - Country:US
Practice Address - Phone:402-245-2825
Practice Address - Fax:402-245-2022
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2015006325103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2015006325Medicaid