Provider Demographics
NPI:1336262815
Name:MORTON, JULIE RENEE (MS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RENEE
Last Name:MORTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 N ROBBS LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-9454
Mailing Address - Country:US
Mailing Address - Phone:812-334-3160
Mailing Address - Fax:812-334-3153
Practice Address - Street 1:4701 N ROBBS LN
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-9454
Practice Address - Country:US
Practice Address - Phone:812-334-3160
Practice Address - Fax:812-334-3153
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities