Provider Demographics
NPI:1972387850
Name:DONELSON, JULIA FRANCES (LAC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:FRANCES
Last Name:DONELSON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SALEM WOODSTOWN RD STE 8
Mailing Address - Street 2:
Mailing Address - City:MANNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08079-2034
Mailing Address - Country:US
Mailing Address - Phone:609-221-0494
Mailing Address - Fax:
Practice Address - Street 1:330 SALEM WOODSTOWN RD STE 8
Practice Address - Street 2:
Practice Address - City:MANNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08079-2034
Practice Address - Country:US
Practice Address - Phone:609-221-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00739300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health