Provider Demographics
NPI:1629477104
Name:BABYAK, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BABYAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 PRESIDENTIAL DR
Mailing Address - Street 2:APARTMENT 120
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1278
Mailing Address - Country:US
Mailing Address - Phone:330-704-6862
Mailing Address - Fax:
Practice Address - Street 1:1344 PRESIDENTIAL DR
Practice Address - Street 2:APARTMENT 120
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1278
Practice Address - Country:US
Practice Address - Phone:330-704-6862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3151599103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool