Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 012563 | NY |
Y | 103TC0700X | Clinical Psychologist | 012563 | NY |
NPI | 1003839226 |
---|---|
Provider Name | Dr. Terri Julian |
First Address | Baltimore, MD 21201-5640 |
Second Address | Baltimore, MD 21201-2825 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 13/11/2012 |