Provider Demographics
NPI:1679825848
Name:WALDRUP, JULIA ANN (MS)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:WALDRUP
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ANN
Other - Last Name:CONDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3228 AVOCET LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-7386
Mailing Address - Country:US
Mailing Address - Phone:918-695-8542
Mailing Address - Fax:
Practice Address - Street 1:3228 AVOCET LN
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-7386
Practice Address - Country:US
Practice Address - Phone:918-695-8542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor