Organization
MY THERAPIST JULIE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE GODDARD MARTIN LMHC (PRESIDENT)
(813) 858-7663
Entity
Organization
Contact information
Practice address
3825 HENDERSON BLVD, SUITE 405, TAMPA, FL 33629-5037
(813) 858-7663
(239) 307-2395
Mailing address
1710 W FORE DR, TAMPA, FL 33612-5022
(813) 858-7663
(239) 307-2395
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH11025
FL
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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