Provider Demographics
NPI:1447081922
Name:KAMINSKI, JULIE D
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:D
Last Name:KAMINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SMITH ST UNIT 301
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1895
Mailing Address - Country:US
Mailing Address - Phone:908-303-6614
Mailing Address - Fax:
Practice Address - Street 1:31 SMITH ST UNIT 301
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1895
Practice Address - Country:US
Practice Address - Phone:908-303-6614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA525932638171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach