| Doctor Name: | JULIE BOARDSEN-BEAN |
| NPI Number: | 1518169119 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 001584 |
| Business Practice Address: | 7 Masons Island Rd Mystic, CT - 063552938 |
| Business Phone Number: | 8605362145 |
| Business Fax Number: | |
| Mailing Address: | Po Box 103, WEST MYSTIC |
| State: | CT |
| Postal Code: | 063880103 |
| Phone Number: | 8605362145 |
| Fax Number: | |
| NPI Enumeration Date: | 06/05/2007 |
| NPI Last Update Date: | 03/26/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 001584 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |