Provider Demographics
NPI:1871621599
Name:WASKIEWICZ, JULIA ANN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN
Last Name:WASKIEWICZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 SEVEN MILE FERRY ROAD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040
Mailing Address - Country:US
Mailing Address - Phone:931-241-7161
Mailing Address - Fax:931-906-9229
Practice Address - Street 1:2035 SEVEN MILE FERRY ROAD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040
Practice Address - Country:US
Practice Address - Phone:931-241-7161
Practice Address - Fax:931-906-9229
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1140106H00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor