Provider Demographics
NPI:1992113849
Name:OKEREKE, JULIE JONES
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:JONES
Last Name:OKEREKE
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 1:310 FORESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7588
Mailing Address - Country:US
Mailing Address - Phone:817-504-4544
Mailing Address - Fax:
Practice Address - Street 1:310 FORESTRIDGE DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7588
Practice Address - Country:US
Practice Address - Phone:817-504-4544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist