Provider Demographics
NPI:1841828209
Name:KUBEK, JULIA BEHEN
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:BEHEN
Last Name:KUBEK
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 1:2158 BROWNING ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1162
Mailing Address - Country:US
Mailing Address - Phone:313-212-7807
Mailing Address - Fax:
Practice Address - Street 1:43155 MAIN ST STE 2300G
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1889
Practice Address - Country:US
Practice Address - Phone:734-323-4897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6351001502103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist