Provider Demographics
NPI:1144028168
Name:STAFFORD, JULIA AILEEN
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:AILEEN
Last Name:STAFFORD
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 1:2040 SUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-6918
Mailing Address - Country:US
Mailing Address - Phone:608-299-4161
Mailing Address - Fax:
Practice Address - Street 1:2040 SUTLER AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-6918
Practice Address - Country:US
Practice Address - Phone:608-299-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst