Provider Demographics
NPI:1598750960
Name:REID, JULIA K (PHD LP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:K
Last Name:REID
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Gender:F
Credentials:PHD LP
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Mailing Address - Street 1:2910 CENTRE POINTE DR
Mailing Address - Street 2:35-121A CHILDRENS HEALTH CARE
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1182
Mailing Address - Country:US
Mailing Address - Phone:651-855-2109
Mailing Address - Fax:651-855-2310
Practice Address - Street 1:2525 CHICAGO AVE
Practice Address - Street 2:CHILDRENS SPECIALTY CLINIC PSYCHOLOGICAL SERVICES MPLS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4518
Practice Address - Country:US
Practice Address - Phone:612-813-8455
Practice Address - Fax:612-813-8263
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MNLP4482103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent