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General NPI Number Information
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NPI Number | 1629091137
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Entity Type | Individual
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Provider Name | JULIE B. WOLTER PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 426 SCRABBLETOWN RD # A-1
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-3664
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Country | US
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Telephone | 603-340-1167
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Fax |
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Provider Business Mailing Address
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Address Line | 268 OLD COACH RD
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City | CHARLESTOWN
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State | RI
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Zip | 02813-3417
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Country | US
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Telephone | 603-340-1167
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1078
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License Number State | NH
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