| Doctor Name: | MRS. JULIE ANNA BULLEN |
| NPI Number: | 1174904924 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 284563-3501 |
| Business Practice Address: | 2300 Monitor Drive Park City, UT - 84060 |
| Business Phone Number: | 8012430236 |
| Business Fax Number: | |
| Mailing Address: | 833 E 9400 S, SANDY |
| State: | UT |
| Postal Code: | 840943655 |
| Phone Number: | 8015662556 |
| Fax Number: | 8015662639 |
| NPI Enumeration Date: | 06/17/2015 |
| NPI Last Update Date: | 06/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 284563-3501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |