Provider Demographics
NPI:1497880769
Name:ROBERT, JULIE LYNN (LLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:ROBERT
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 CAPITAL AVE SW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-7375
Mailing Address - Country:US
Mailing Address - Phone:269-979-8333
Mailing Address - Fax:269-979-7766
Practice Address - Street 1:2149 JOLLY RD STE 500
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-6028
Practice Address - Country:US
Practice Address - Phone:517-347-4645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011950103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling