Healthcare Provider Details

I. General information

NPI: 1477792158
Provider Name (Legal Business Name): JULIE C DUVALL PHD CANDIDATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13801 E. BENSON HIGHWAY
VAIL AZ
85641
US

IV. Provider business mailing address

13801 E. BENSON HIGHWAY
VAIL AZ
85641
US

V. Phone/Fax

Practice location:
  • Phone: 520-879-3161
  • Fax: 520-879-2088
Mailing address:
  • Phone: 520-879-3161
  • Fax: 520-879-2088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: