Healthcare Provider Details

I. General information

NPI: 1588713283
Provider Name (Legal Business Name): JULIE SUE URAN PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 S MAIN ST SUITE 304
BUTLER PA
16001-5987
US

IV. Provider business mailing address

185 FORRESTER RD
SLIPPERY ROCK PA
16057-2515
US

V. Phone/Fax

Practice location:
  • Phone: 724-287-5604
  • Fax: 724-287-3779
Mailing address:
  • Phone: 724-794-1954
  • Fax: 724-794-1905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS005709L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: