Provider Demographics
NPI:1982779781
Name:THOMLEY, JULIE ELLEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ELLEN
Last Name:THOMLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:ELLEN
Other - Last Name:THOMLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:2300 LAKEVIEW PKWY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-7982
Mailing Address - Country:US
Mailing Address - Phone:770-993-1003
Mailing Address - Fax:678-916-3889
Practice Address - Street 1:2300 LAKEVIEW PKWY
Practice Address - Street 2:SUITE 700
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-7982
Practice Address - Country:US
Practice Address - Phone:770-993-1003
Practice Address - Fax:678-916-3889
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1486103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1486OtherLICENSE #
GA1486OtherLICENSE #
GANPP000Medicare UPIN