Healthcare Provider Details

I. General information

NPI: 1083522999
Provider Name (Legal Business Name): JULIA TEPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N STEPHENSON HWY
ROYAL OAK MI
48067-1580
US

IV. Provider business mailing address

52536 BELLE VERNON
SHELBY TWP MI
48316-2921
US

V. Phone/Fax

Practice location:
  • Phone: 248-221-2766
  • Fax: 248-251-0270
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6362010399
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: