Provider Demographics
NPI:1780227348
Name:BREAUX, JULIE C (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:C
Last Name:BREAUX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28316 ROSE OAK ST
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-8126
Mailing Address - Country:US
Mailing Address - Phone:985-792-5260
Mailing Address - Fax:
Practice Address - Street 1:28316 ROSE OAK ST
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-8126
Practice Address - Country:US
Practice Address - Phone:985-792-5260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
LA4602101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional