Provider Demographics
NPI:1639873052
Name:ATTALLA, JULIE (LAC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ATTALLA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 PINE NEEDLE ST
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2687
Mailing Address - Country:US
Mailing Address - Phone:908-839-7786
Mailing Address - Fax:
Practice Address - Street 1:126 PINE NEEDLE ST
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2687
Practice Address - Country:US
Practice Address - Phone:908-839-7786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00706100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health