Healthcare Provider Details

I. General information

NPI: 1851944516
Provider Name (Legal Business Name): JULIA CLAIR HUSTON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 UNIVERSITY BLVD
DUBLIN OH
43016-3508
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-9600
  • Fax: 614-293-1456
Mailing address:
  • Phone: 614-293-9600
  • Fax: 614-293-1456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.08579
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberP.08579
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number06107
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: