Provider Demographics
NPI:1629091137
Name:WOLTER, JULIE B (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:B
Last Name:WOLTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 OLD COACH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02813-3417
Mailing Address - Country:US
Mailing Address - Phone:603-340-1167
Mailing Address - Fax:
Practice Address - Street 1:426 SCRABBLETOWN RD # A-1
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-3664
Practice Address - Country:US
Practice Address - Phone:603-340-1167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1078103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist