Doctor Name: | MRS. JULIE ANNA SCHAEFER SPACE |
NPI Number: | 1730240359 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, MLLP |
License Number: | 6301007868 |
Business Practice Address: | 402 Thornton St Middleville, MI - 493339706 |
Business Phone Number: | 2697952243 |
Business Fax Number: | 2697955315 |
Mailing Address: | P.o. Box 339, 402 Thornton Street MIDDLEVILLE |
State: | MI |
Postal Code: | 493334209 |
Phone Number: | 2697952243 |
Fax Number: | 2697955315 |
NPI Enumeration Date: | 12/13/2006 |
NPI Last Update Date: | 02/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TB0200X |
License Number: | 6301007868 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Cognitive & Behavioral |
Taxonomy Definition: |