Provider Demographics
NPI:1790858983
Name:HALOUA, JULIE ANN (OD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:HALOUA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-3838
Mailing Address - Country:US
Mailing Address - Phone:814-234-7788
Mailing Address - Fax:814-234-1105
Practice Address - Street 1:138 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-3838
Practice Address - Country:US
Practice Address - Phone:814-234-7788
Practice Address - Fax:814-234-1105
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001489152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist