Provider Demographics
NPI:1447904362
Name:MEEHAN MORONEY, JULIA ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:ELIZABETH
Last Name:MEEHAN MORONEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-2164
Mailing Address - Country:US
Mailing Address - Phone:321-890-8492
Mailing Address - Fax:
Practice Address - Street 1:4237 S PIPKIN RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33811-1442
Practice Address - Country:US
Practice Address - Phone:863-701-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical