Healthcare Provider Details

I. General information

NPI: 1699641266
Provider Name (Legal Business Name): JULIE PALMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 BROOK PARK PL STE A1
FOREST VA
24551-2766
US

IV. Provider business mailing address

316 BROOK PARK PL STE A1
FOREST VA
24551-2766
US

V. Phone/Fax

Practice location:
  • Phone: 434-533-1088
  • Fax: 434-664-1177
Mailing address:
  • Phone: 434-533-1088
  • Fax: 434-664-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701015993
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: