Provider Demographics
NPI:1457753261
Name:STEINHARDT, JULIE (EDS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:STEINHARDT
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W YOUNG ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43532-9639
Mailing Address - Country:US
Mailing Address - Phone:419-367-2120
Mailing Address - Fax:
Practice Address - Street 1:103 W YOUNG ST
Practice Address - Street 2:
Practice Address - City:LIBERTY CENTER
Practice Address - State:OH
Practice Address - Zip Code:43532-9639
Practice Address - Country:US
Practice Address - Phone:419-367-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3021282103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool