Provider Demographics
NPI:1346642865
Name:CAUDLE, JULIE ANGELICA (MMFT, LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANGELICA
Last Name:CAUDLE
Suffix:
Gender:F
Credentials:MMFT, LMFTA
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:ANGELICA
Other - Last Name:CHILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 SUGAR CREEK CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-2210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-2210
Practice Address - Country:US
Practice Address - Phone:832-736-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201953106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist