Provider Demographics
NPI:1740461847
Name:SPRENKLE, JULIE MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE
Last Name:SPRENKLE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 MAIN ST
Mailing Address - Street 2:SUITE 2D1
Mailing Address - City:DALTON
Mailing Address - State:MA
Mailing Address - Zip Code:01226-1612
Mailing Address - Country:US
Mailing Address - Phone:413-684-4696
Mailing Address - Fax:815-572-8941
Practice Address - Street 1:399 MAIN ST
Practice Address - Street 2:SUITE 2D1
Practice Address - City:DALTON
Practice Address - State:MA
Practice Address - Zip Code:01226-1612
Practice Address - Country:US
Practice Address - Phone:413-684-4696
Practice Address - Fax:815-572-8941
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8762103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical