Provider Demographics
NPI:1295247708
Name:PLOYER, JULIE TERESA (MS, BCBA)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:TERESA
Last Name:PLOYER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:TERESA
Other - Last Name:WIECHEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4078 EDENBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-7641
Mailing Address - Country:US
Mailing Address - Phone:508-873-3221
Mailing Address - Fax:
Practice Address - Street 1:704 21ST AVE N
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-7400
Practice Address - Country:US
Practice Address - Phone:845-625-8248
Practice Address - Fax:845-625-8248
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst