Provider Demographics
NPI:1972056711
Name:GAW, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GAW
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 1:70 HOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-1545
Mailing Address - Country:US
Mailing Address - Phone:973-809-8253
Mailing Address - Fax:401-253-0003
Practice Address - Street 1:70 HOOD AVE
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:RI
Practice Address - Zip Code:02916-1545
Practice Address - Country:US
Practice Address - Phone:973-809-8253
Practice Address - Fax:401-253-0003
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10000315101YM0800X
101YM0800X
RIMHC01137101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health