Provider Demographics
NPI:1477741080
Name:HAAG, JULIE CARDOSI (BSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:CARDOSI
Last Name:HAAG
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:LOUISE
Other - Last Name:CARDOSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:2306 PIKE WOOD DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-4625
Mailing Address - Country:US
Mailing Address - Phone:901-737-9035
Mailing Address - Fax:901-369-1433
Practice Address - Street 1:3810 WINCHESTER RD
Practice Address - Street 2:SOUTHEAST MENTAL HEALTH CENTER
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-6045
Practice Address - Country:US
Practice Address - Phone:901-369-1400
Practice Address - Fax:901-369-1433
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator