Provider Demographics
NPI:1396500617
Name:FLEENOR, JULIE BOYD (MS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:BOYD
Last Name:FLEENOR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3122 BACK ACRES RD
Mailing Address - Street 2:
Mailing Address - City:EFLAND
Mailing Address - State:NC
Mailing Address - Zip Code:27243-9465
Mailing Address - Country:US
Mailing Address - Phone:919-452-1704
Mailing Address - Fax:
Practice Address - Street 1:3122 BACK ACRES RD
Practice Address - Street 2:
Practice Address - City:EFLAND
Practice Address - State:NC
Practice Address - Zip Code:27243-9465
Practice Address - Country:US
Practice Address - Phone:919-452-1704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16417101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health