Provider Demographics
NPI:1215067624
Name:WEKKIN, JULIA M (MS LPE)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:M
Last Name:WEKKIN
Suffix:
Gender:F
Credentials:MS LPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SALEM ROAD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034
Mailing Address - Country:US
Mailing Address - Phone:479-967-5570
Mailing Address - Fax:479-890-5364
Practice Address - Street 1:350 SALEM ROAD
Practice Address - Street 2:SUITE #1
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034
Practice Address - Country:US
Practice Address - Phone:479-967-5570
Practice Address - Fax:479-890-5364
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9301E101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health