Healthcare Provider Details
I. General information
NPI: 1013984277
Provider Name (Legal Business Name): JULIE REED NEAL LPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/07/2006
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
132 POPLAR GROVE CONNECTOR SUITE B
BOONE NC
28607-5915
US
IV. Provider business mailing address
132 POPLAR GROVE CONNECTOR SUITE B
BOONE NC
28607-5915
US
V. Phone/Fax
- Phone: 828-264-8759
- Fax: 828-262-5687
- Phone: 828-264-8759
- Fax: 828-262-5687
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 1530 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: