Provider Demographics
NPI:1568677276
Name:OWEN-SHOAL, JULIA CADE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:CADE
Last Name:OWEN-SHOAL
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:CADE
Other - Last Name:TESCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2130 9TH ST W # 118
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-4416
Mailing Address - Country:US
Mailing Address - Phone:406-298-9252
Mailing Address - Fax:
Practice Address - Street 1:2130 9TH ST W # 118
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-4416
Practice Address - Country:US
Practice Address - Phone:406-298-9252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPSY-PSY-LIC-5566103TC0700X
FLPY7868103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical