Provider Demographics
NPI:1558335570
Name:HARPER, JULIE (PSY-D)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:PSY-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 BOULDER ST
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536-2251
Mailing Address - Country:US
Mailing Address - Phone:850-226-7322
Mailing Address - Fax:850-226-7491
Practice Address - Street 1:151 MARY ESTHER BLVD
Practice Address - Street 2:STE 308A
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1972
Practice Address - Country:US
Practice Address - Phone:850-226-7322
Practice Address - Fax:850-226-7491
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7168103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU5773ZMedicare ID - Type Unspecified