Healthcare Provider Details

I. General information

NPI: 1558400044
Provider Name (Legal Business Name): JULIA TANDY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 11/01/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ARMY HEALTH CLINIC ANSBACH URLAS KASERNE COMANCHE BLVD. BLD 8156
ANSBACH BAVARIA
91522
DE

IV. Provider business mailing address

UNIT 28747 BOX 6537
APO AE
09177-8747
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-3726
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number991
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: