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NPI Code Detail

MEDICARE: DR. JULIA CONNELLY PH.D.

MEDICARE: DR. JULIA CONNELLY PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist6307968-2501UT

General Provider Information

NPI Number : 1396915609
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIA CONNELLY PH.D.
Provider Business Mailing Address
First Line : 1537 S MAIN ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-5315
Country : US
Telephone Number : 385-777-9444
Fax Number :
Provider Business Practice Location Address
First Line : 1537 S MAIN ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-5315
Country : US
Telephone Number : 385-777-9444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2008
Last Update Date : 09/09/2024

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Directions to “ DR. JULIA CONNELLY PH.D.” Practice Location

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