Provider Demographics
NPI:1306238357
Name:FIELD, JULIE L
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:FIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5050 COOPERS LANDING DR APT 3C
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49004-6666
Mailing Address - Country:US
Mailing Address - Phone:616-566-8231
Mailing Address - Fax:
Practice Address - Street 1:5050 COOPERS LANDING DR APT 3C
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49004-6666
Practice Address - Country:US
Practice Address - Phone:616-566-8231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-28
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
MI11934496103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other