Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY01560 | MO |
Y | 103TC0700X | Clinical Psychologist | PY01560 | MO |
NPI | 1013038413 |
---|---|
Provider Name | Dr. Julie Chasen Paull |
First Address | Ellisville, MO 63011-2173 |
Second Address | Ellisville, MO 63011-2173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 17/03/2014 |