Individual
JULIE MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2555 UNIVERSITY DR, FAIRBORN, OH 45324-6255
(937) 775-7792
Mailing address
2555 UNIVERSITY DR, FAIRBORN, OH 45324-6255
(937) 775-7792
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
57.251765
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2021
Last updated
07/06/2023
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