Provider Demographics
NPI:1730490335
Name:OVALLE, JULIA (LICSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:OVALLE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1671
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03802-0138
Mailing Address - Country:US
Mailing Address - Phone:603-212-6068
Mailing Address - Fax:
Practice Address - Street 1:7 GREENLEAF WOODS DR
Practice Address - Street 2:UNIT 202
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5444
Practice Address - Country:US
Practice Address - Phone:603-212-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical