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General NPI Number Information
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NPI Number | 1376740787
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Entity Type | Individual
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Provider Name | KRISTIE SUE JULIEN D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 11/15/2013
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Provider Practice Location Address
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Address Line | 282 LAGO VISTA CIR
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City | BOUNTIFUL
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State | UT
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Zip | 84010-1821
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Country | US
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Telephone | 801-678-1083
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Fax |
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Provider Business Mailing Address
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Address Line | 282 LAGO VISTA CIR
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City | BOUNTIFUL
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State | UT
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Zip | 84010-1821
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Country | US
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Telephone | 801-678-1083
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 7738449-1204
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 7738449-1204
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License Number State | UT
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