Provider Demographics
NPI:1144629395
Name:KRIZAY, JULIE MICHELLE (EDS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MICHELLE
Last Name:KRIZAY
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 N SPRING RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-1888
Mailing Address - Country:US
Mailing Address - Phone:614-797-7280
Mailing Address - Fax:
Practice Address - Street 1:270 N SPRING RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-1888
Practice Address - Country:US
Practice Address - Phone:614-797-7280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3056180103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool