Provider Demographics
NPI:1124235619
Name:HUTCHINS-WILSON, JULIE MARIE (MS, NCC)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MARIE
Last Name:HUTCHINS-WILSON
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 SW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-7507
Mailing Address - Country:US
Mailing Address - Phone:954-873-7273
Mailing Address - Fax:954-523-1669
Practice Address - Street 1:5451 N UNIVERSITY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4641
Practice Address - Country:US
Practice Address - Phone:954-227-0551
Practice Address - Fax:954-523-1669
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT979106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist