| Organization Name: | JULIE B. SHIFFLER, PHD, PC |
| NPI Number: | 1235210865 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIE B. SHIFFLER (PRESIDENT) |
| Mailing Address: | 2404 N 3000 W Rexburg |
| State: | ID US |
| Postal Code: | 834403126 |
| Phone Number: | 2082016690 |
| Fax Number: | 2084961238 |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY-378 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |