Provider Demographics
NPI:1063233393
Name:CONTI, JULIA ADA (MS)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ADA
Last Name:CONTI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 NW 16TH ST APT 208
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5100
Mailing Address - Country:US
Mailing Address - Phone:954-610-3735
Mailing Address - Fax:
Practice Address - Street 1:6201 SW 180TH TER
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33331-1611
Practice Address - Country:US
Practice Address - Phone:954-547-9928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-19
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT4256106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist