Provider Demographics
NPI:1376237495
Name:BASSI, JULIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:BASSI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 N MAIN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4926
Mailing Address - Country:US
Mailing Address - Phone:603-491-5398
Mailing Address - Fax:
Practice Address - Street 1:18 N MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4926
Practice Address - Country:US
Practice Address - Phone:603-491-5398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1112103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist