Provider Demographics
NPI:1285102376
Name:BUTLER, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2532 DAFFADIL TER
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6840
Mailing Address - Country:US
Mailing Address - Phone:954-593-2870
Mailing Address - Fax:386-243-4581
Practice Address - Street 1:1642 N VOLUSIA AVE STE 201
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-3850
Practice Address - Country:US
Practice Address - Phone:386-628-0295
Practice Address - Fax:386-243-4581
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician