Provider Demographics
NPI:1376224501
Name:BUBEN, JULIA LEIGH
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:LEIGH
Last Name:BUBEN
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 1:72 GORE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1483
Mailing Address - Country:US
Mailing Address - Phone:401-489-3378
Mailing Address - Fax:
Practice Address - Street 1:1 WESTINGHOUSE PLZ
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-2075
Practice Address - Country:US
Practice Address - Phone:617-910-9605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health