Provider Demographics
NPI:1306325345
Name:KUNHARDT, JULIA E (LICSW)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:E
Last Name:KUNHARDT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:E
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-1754
Mailing Address - Country:US
Mailing Address - Phone:800-524-4010
Mailing Address - Fax:617-246-4281
Practice Address - Street 1:1 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-1754
Practice Address - Country:US
Practice Address - Phone:800-524-4010
Practice Address - Fax:617-246-4281
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1107281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical