Provider Demographics
NPI:1235979550
Name:MIMS, JULIA (BS FNTP RWP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:MIMS
Suffix:
Gender:F
Credentials:BS FNTP RWP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12730 FAIRWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-1882
Mailing Address - Country:US
Mailing Address - Phone:985-232-2496
Mailing Address - Fax:
Practice Address - Street 1:12730 FAIRWOOD CT
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-1882
Practice Address - Country:US
Practice Address - Phone:985-232-2496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach