Individual
JULIE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
920 N SHADELAND AVE, SUITE G-6A, INDIANAPOLIS, IN 46219-4898
(317) 600-1620
Mailing address
1229 N HAWTHORNE LN, INDIANAPOLIS, IN 46219-2941
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20041897A
IN
103TC0700X
Clinical Psychologist
Primary
20041897A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000322924
ANTHEM
IN
05
—
200260480A
—
IN
01
—
P00217244
RAILROAD MEDICARE
IN
Enumeration date
06/16/2006
Last updated
05/16/2012
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