Provider Demographics
NPI:1588919302
Name:WILHELM, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:WILHELM
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 1:44 DREAM AVE.
Mailing Address - Street 2:
Mailing Address - City:DELCO
Mailing Address - State:NC
Mailing Address - Zip Code:28436-8700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:44 DREAM AVE
Practice Address - Street 2:
Practice Address - City:DELCO
Practice Address - State:NC
Practice Address - Zip Code:28436-8700
Practice Address - Country:US
Practice Address - Phone:330-312-4546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional