Provider Demographics
NPI:1043068190
Name:MOELLER, JULIE (MA)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MOELLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 BRAESIDE SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1768
Mailing Address - Country:US
Mailing Address - Phone:317-430-0406
Mailing Address - Fax:
Practice Address - Street 1:54 N 9TH ST STE 260
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2208
Practice Address - Country:US
Practice Address - Phone:317-430-0406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health