Provider Demographics
NPI:1013036102
Name:STEVENS, JULIA (MPH, RDN)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32988 THORNDYKE CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1969
Mailing Address - Country:US
Mailing Address - Phone:248-459-1508
Mailing Address - Fax:
Practice Address - Street 1:32988 THORNDYKE CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1969
Practice Address - Country:US
Practice Address - Phone:248-459-1508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
MI959616133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered