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NPI Code Detail

MEDICARE: DR. TRACY RENEA JULIAO PH.D.

MEDICARE: DR. TRACY RENEA JULIAO 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
1103TH0100XHealth Service Psychologist630101980MI

General Provider Information

NPI Number : 1447350202
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACY RENEA JULIAO PH.D.
Provider Business Mailing Address
First Line : PO BOX 3052
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48333-3052
Country : US
Telephone Number : 734-368-7154
Fax Number :
Provider Business Practice Location Address
First Line : 23580 ORCHARD LAKE RD
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48336-3241
Country : US
Telephone Number : 248-957-6444
Fax Number : 248-477-4442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 08/18/2024

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