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General NPI Number Information
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NPI Number | 1528274909
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Entity Type | Organization
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Legal Business Name | JULIA H. GREEN, PH.D., LLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2550 GILLUMS RIDGE LN
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-7610
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Country | US
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Telephone | 434-962-8082
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 GILLUMS RIDGE LN
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-7610
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Country | US
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Telephone | 434-962-8082
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Fax |
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Authorized Official
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Title or Position | CHILD PSYCHOLOGIST
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Name | DR. JULIA HAMMOND GREEN
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Credential |
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Telephone | 434-962-8082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 0810001034
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License Number State | VA
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