Provider Demographics
NPI:1386072114
Name:DORLAND, JULIE (MS SCHOOL PSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:DORLAND
Suffix:
Gender:F
Credentials:MS SCHOOL PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 SHIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1437
Mailing Address - Country:US
Mailing Address - Phone:541-968-2447
Mailing Address - Fax:
Practice Address - Street 1:2334 SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-1437
Practice Address - Country:US
Practice Address - Phone:541-968-2447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR810435103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool