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General NPI Number Information
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NPI Number | 1609299106
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Entity Type | Individual
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Provider Name | JULIEN PERILLE PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 01/26/2025
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Provider Practice Location Address
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Address Line | 21 GOTHAM WOODS
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City | WOOLWICH
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State | ME
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Zip | 04579-4914
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Country | US
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Telephone | 207-619-0608
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Fax |
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Provider Business Mailing Address
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Address Line | 10 STATE RD. STE 9 #1027
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City | BATH
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State | ME
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Zip | 04530-6020
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Country | US
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Telephone | 207-619-0608
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS1374
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License Number State | ME
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