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General NPI Number Information
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NPI Number | 1194032276
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Entity Type | Individual
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Provider Name | JULIA H PETERSON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 16535 W BLUEMOUND RD
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City | BROOKFIELD
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State | WI
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Zip | 53005-5936
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Country | US
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Telephone | 262-789-1191
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Fax |
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Provider Business Mailing Address
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Address Line | 1557 S 82ND ST
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City | WEST ALLIS
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State | WI
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Zip | 53214-4422
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Country | US
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Telephone | 414-429-6061
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5116-057
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5079-125
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License Number State | WI
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