Provider Demographics
NPI:1841017845
Name:GREENE, JULIA (MED, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4617 GANYMEDE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-5150
Mailing Address - Country:US
Mailing Address - Phone:760-987-1199
Mailing Address - Fax:
Practice Address - Street 1:13581 POND SPRINGS RD STE 400
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-4426
Practice Address - Country:US
Practice Address - Phone:512-364-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-24-75299103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst