Provider Demographics
NPI:1306419890
Name:MORIARITY, JULIA ELLEN (RBT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ELLEN
Last Name:MORIARITY
Suffix:
Gender:F
Credentials:RBT
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Other - Middle Name:
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Mailing Address - Street 1:6816 SOUTHPOINT PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1701
Mailing Address - Country:US
Mailing Address - Phone:904-419-7792
Mailing Address - Fax:904-900-7732
Practice Address - Street 1:12025 SAN JOSE BLVD STE 2
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-1639
Practice Address - Country:US
Practice Address - Phone:904-419-7792
Practice Address - Fax:904-900-7732
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RBT-21-168726106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician