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General NPI Number Information
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NPI Number | 1073962148
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Entity Type | Organization
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Legal Business Name | JULIE M LESPERANCE, PSY.D., PLLC
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 3013 N 67TH PL STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6169
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Country | US
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Telephone | 480-550-1776
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3742
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City | SCOTTSDALE
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State | AZ
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Zip | 85271-3742
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Country | US
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Telephone | 480-550-1776
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JULIE MARIE LESPERANCE
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Credential | PSY.D.
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Telephone | 480-550-1776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4629
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License Number State | AZ
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