Provider Demographics
NPI:1457039216
Name:LOVELL, JULIE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:M
Last Name:LOVELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 UNION AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-3430
Mailing Address - Country:US
Mailing Address - Phone:616-581-1830
Mailing Address - Fax:
Practice Address - Street 1:20 UNION AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-3430
Practice Address - Country:US
Practice Address - Phone:616-581-1830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty