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General NPI Number Information
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NPI Number | 1275084451
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Entity Type | Individual
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Provider Name | JULIE RICHARDSON LPCA
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Gender | Female
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Dates
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Enumeration Date | 10/21/2016
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Last Update Date | 10/22/2016
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Provider Practice Location Address
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Address Line | 1143 FAIRWAY ST SUITE 103
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City | BOWLING GREEN
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State | KY
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Zip | 42103-2452
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Country | US
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Telephone | 270-904-6307
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Fax | 270-904-6314
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Provider Business Mailing Address
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Address Line | 1143 FAIRWAY ST SUITE 103
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City | BOWLING GREEN
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State | KY
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Zip | 42103-2452
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Country | US
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Telephone | 270-904-6307
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Fax | 270-904-6314
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1391
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License Number State | KY
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