Provider Demographics
NPI:1952657967
Name:TREVILLION, JULIA MENYON (MHR)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:MENYON
Last Name:TREVILLION
Suffix:
Gender:F
Credentials:MHR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 RIDGECREST CIR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-7535
Mailing Address - Country:US
Mailing Address - Phone:918-706-9913
Mailing Address - Fax:
Practice Address - Street 1:6418 N. SANTA FA
Practice Address - Street 2:SUITE C
Practice Address - City:OKC
Practice Address - State:OK
Practice Address - Zip Code:73116
Practice Address - Country:US
Practice Address - Phone:405-242-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst