Provider Demographics
NPI:1477014298
Name:VLAKIC, JULIE A (ED, M)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:VLAKIC
Suffix:
Gender:F
Credentials:ED, M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 MADISON ST APT 412
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-6488
Mailing Address - Country:US
Mailing Address - Phone:201-739-8667
Mailing Address - Fax:
Practice Address - Street 1:8 KLEIN CT
Practice Address - Street 2:
Practice Address - City:OLD TAPPAN
Practice Address - State:NJ
Practice Address - Zip Code:07675-6826
Practice Address - Country:US
Practice Address - Phone:201-981-3742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician