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General NPI Number Information
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NPI Number | 1720288202
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Entity Type | Individual
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Provider Name | JULIE SHIN
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Gender | Female
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1650 COCHRANE CIR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80913-4613
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Country | US
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Telephone | 650-279-2717
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 COCHRANE CIR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80913-4613
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Country | US
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Telephone |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60155490
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License Number State | WA
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