Provider Demographics
NPI:1447734389
Name:SPROTZER, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SPROTZER
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 1:35 LILY POND CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-4028
Mailing Address - Country:US
Mailing Address - Phone:908-251-1944
Mailing Address - Fax:
Practice Address - Street 1:180A TICES LN STE 202
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1337
Practice Address - Country:US
Practice Address - Phone:732-354-0050
Practice Address - Fax:732-325-0334
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06185100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker