Provider Demographics
NPI:1154806735
Name:BABOS, JULIA KATHRYN
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:KATHRYN
Last Name:BABOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 RIDGECREST RD
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37074-3713
Mailing Address - Country:US
Mailing Address - Phone:615-342-9202
Mailing Address - Fax:
Practice Address - Street 1:65 RIDGECREST RD
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37074-3713
Practice Address - Country:US
Practice Address - Phone:615-342-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5204133V00000X
133V00000X
GALD005210133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered