Provider Demographics
NPI:1568165090
Name:OSPINO, JULIO D
Entity type:Individual
Prefix:MR
First Name:JULIO
Middle Name:D
Last Name:OSPINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 DANBURY RD APT 6
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4105
Mailing Address - Country:US
Mailing Address - Phone:203-815-4933
Mailing Address - Fax:
Practice Address - Street 1:25028 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-9310
Practice Address - Country:US
Practice Address - Phone:206-764-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health