Provider Demographics
NPI:1316089998
Name:BOYER, JULIE MARGARET (PHD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MARGARET
Last Name:BOYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 BUFORD HIGHWAY STE 550A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2124
Mailing Address - Country:US
Mailing Address - Phone:404-636-9402
Mailing Address - Fax:
Practice Address - Street 1:2801 BUFORD HIGHWAY STE 550A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2124
Practice Address - Country:US
Practice Address - Phone:404-636-9402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000793103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA06BDHCZMedicare UPIN