Provider Demographics
NPI:1750028544
Name:ARISTYLD, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ARISTYLD
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 1:20682 NE 2ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2992
Mailing Address - Country:US
Mailing Address - Phone:754-204-1986
Mailing Address - Fax:
Practice Address - Street 1:20682 NE 2ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2992
Practice Address - Country:US
Practice Address - Phone:754-204-1986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW19575104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker