Healthcare Provider Details

I. General information

NPI: 1669208914
Provider Name (Legal Business Name): JULIANN COCHRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 E 100 S
CASTLE DALE UT
84513-4508
US

IV. Provider business mailing address

PO BOX 867
PRICE UT
84501-0867
US

V. Phone/Fax

Practice location:
  • Phone: 435-381-2432
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5604562-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: