Provider Demographics
NPI:1285835504
Name:POWERS, JULIE MRUZ (MSSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MRUZ
Last Name:POWERS
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 DIANA LN
Mailing Address - Street 2:
Mailing Address - City:VINE GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:40175-6369
Mailing Address - Country:US
Mailing Address - Phone:270-668-8063
Mailing Address - Fax:270-828-3240
Practice Address - Street 1:50 DIANA LN
Practice Address - Street 2:
Practice Address - City:VINE GROVE
Practice Address - State:KY
Practice Address - Zip Code:40175-6369
Practice Address - Country:US
Practice Address - Phone:270-668-8063
Practice Address - Fax:270-828-3240
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator