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General NPI Number Information
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NPI Number | 1316142912
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Entity Type | Individual
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Provider Name | JULIE ANNE MOREIRA BABALOLA LSW LCSWA
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Gender | Female
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1515 MOCKINGBIRD LN # 420
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City | CHARLOTTE
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State | NC
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Zip | 28209-3236
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Country | US
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Telephone | 704-293-2694
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 443
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City | MATTHEWS
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State | NC
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Zip | 28106-0443
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Country | US
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Telephone | 704-293-2694
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Fax | 704-803-8372
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW125282
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P018815
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License Number State | NC
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