Provider Demographics
NPI:1396007043
Name:INGENOHL, JULIE LYNN (MS MFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:INGENOHL
Suffix:
Gender:F
Credentials:MS MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 ZEYA DR
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:CT
Mailing Address - Zip Code:06238-1035
Mailing Address - Country:US
Mailing Address - Phone:860-268-6985
Mailing Address - Fax:
Practice Address - Street 1:58 ZEYA DR
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:CT
Practice Address - Zip Code:06238-1035
Practice Address - Country:US
Practice Address - Phone:860-268-6985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist