Provider Demographics
NPI:1396974010
Name:WEINER-DABDA, JULIE M (MC, NCC, LPC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:M
Last Name:WEINER-DABDA
Suffix:
Gender:F
Credentials:MC, NCC, LPC
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:M
Other - Last Name:WEINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MC, NCC, LPC
Mailing Address - Street 1:9486 N SAMMY AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8366
Mailing Address - Country:US
Mailing Address - Phone:520-661-6718
Mailing Address - Fax:520-577-1339
Practice Address - Street 1:2120 W INA RD
Practice Address - Street 2:STE 103E
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2694
Practice Address - Country:US
Practice Address - Phone:520-661-6718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-12736101Y00000X
AZLPC-13264101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor