Provider Demographics
NPI:1881653897
Name:DANTZLER, JULIE POPE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:POPE
Last Name:DANTZLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3047
Mailing Address - Country:US
Mailing Address - Phone:863-297-5463
Mailing Address - Fax:863-299-1384
Practice Address - Street 1:391 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3047
Practice Address - Country:US
Practice Address - Phone:863-297-5463
Practice Address - Fax:863-299-1384
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2251101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ5931OtherBCBS NUMBER