Provider Demographics
NPI:1780396580
Name:PLANK, JULIE ELIZABETH
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ELIZABETH
Last Name:PLANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13312 BLACKWATER RD
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-6839
Mailing Address - Country:US
Mailing Address - Phone:225-333-8191
Mailing Address - Fax:
Practice Address - Street 1:13312 BLACKWATER RD
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-6839
Practice Address - Country:US
Practice Address - Phone:225-333-8191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician