Provider Demographics
NPI:1316684186
Name:TOLLU, JULIE A
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:TOLLU
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 1:209 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-2361
Mailing Address - Country:US
Mailing Address - Phone:929-461-5500
Mailing Address - Fax:
Practice Address - Street 1:209 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-2361
Practice Address - Country:US
Practice Address - Phone:929-461-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical