Provider Demographics
NPI:1932457892
Name:BISAILLON, JULIA ANTOINETTE (BA)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ANTOINETTE
Last Name:BISAILLON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CHESTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:MA
Mailing Address - Zip Code:01053-9728
Mailing Address - Country:US
Mailing Address - Phone:413-335-4727
Mailing Address - Fax:
Practice Address - Street 1:24 CHESTERFIELD RD
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-9728
Practice Address - Country:US
Practice Address - Phone:413-335-4727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health