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General NPI Number Information
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NPI Number | 1457917205
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Entity Type | Individual
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Provider Name | JULIA EMMA NAIDITCH ATR-BC, LPAT
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Gender | Female
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 1935 GARDINER LN APT A4
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City | LOUISVILLE
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State | KY
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Zip | 40205-2827
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Country | US
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Telephone | 502-500-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 4010 DUPONT CIR STE 582
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City | LOUISVILLE
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State | KY
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Zip | 40207-4888
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Country | US
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Telephone | 502-424-2562
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 241448
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License Number State | KY
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