Provider Demographics
NPI:1770179368
Name:DILLON, JULIE ANNE (MA, CM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:DILLON
Suffix:
Gender:F
Credentials:MA, CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 GREY FLATS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-5874
Mailing Address - Country:US
Mailing Address - Phone:304-255-7676
Mailing Address - Fax:304-929-6007
Practice Address - Street 1:201 GREY FLATS RD STE 200
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-5874
Practice Address - Country:US
Practice Address - Phone:304-255-7676
Practice Address - Fax:304-929-6007
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator