Provider Demographics
NPI:1851360689
Name:PARSONS, JULIE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:PARSONS
Suffix:
Gender:F
Credentials:PHD
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 9006
Mailing Address - Street 2:0
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83652
Mailing Address - Country:US
Mailing Address - Phone:208-463-1605
Mailing Address - Fax:208-459-3012
Practice Address - Street 1:305 E LOGAN
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605
Practice Address - Country:US
Practice Address - Phone:208-454-1855
Practice Address - Fax:208-459-3012
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY286103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010016346OtherBLUE SHIELD
ID002182400Medicaid
IDN2860OtherBLUE CROSS
ID002182400Medicaid