Individual
KRISTIE SUE JULIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
282 LAGO VISTA CIR, BOUNTIFUL, UT 84010-1821
(801) 678-1083
Mailing address
282 LAGO VISTA CIR, BOUNTIFUL, UT 84010-1821
(801) 678-1083
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
7738449-1204
UT
2084P0804X
Child & Adolescent Psychiatry Physician
7738449-1204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1100
TRAINING LICENSE
AZ
Enumeration date
06/29/2007
Last updated
11/15/2013
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