Provider Demographics
NPI:1346398724
Name:MURRAY, JULIA E (MED)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:E
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 FRONT STREET
Mailing Address - Street 2:SUITE 230
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930
Mailing Address - Country:US
Mailing Address - Phone:307-789-6773
Mailing Address - Fax:307-789-3244
Practice Address - Street 1:724 FRONT STREET
Practice Address - Street 2:SUITE 230
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930
Practice Address - Country:US
Practice Address - Phone:307-789-6773
Practice Address - Fax:307-789-3244
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC327101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY303874Medicare ID - Type Unspecified