Provider Demographics
NPI:1881761674
Name:THOMAS, JULIE D
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:D
Last Name:THOMAS
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 1:2421 CENTRAL AVE APT A
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6249
Mailing Address - Country:US
Mailing Address - Phone:706-726-0365
Mailing Address - Fax:
Practice Address - Street 1:233 DAVIS RD
Practice Address - Street 2:SUITE G
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-2499
Practice Address - Country:US
Practice Address - Phone:706-726-4711
Practice Address - Fax:877-371-1465
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health