Provider Demographics
NPI:1548404338
Name:SAMUELS, JULIA MARCIA (BA)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:MARCIA
Last Name:SAMUELS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WOODLAND ST FL 4
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1233
Mailing Address - Country:US
Mailing Address - Phone:860-520-6218
Mailing Address - Fax:
Practice Address - Street 1:103 WOODLAND ST FL 4
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1233
Practice Address - Country:US
Practice Address - Phone:860-520-6218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker