Provider Demographics
NPI:1275428260
Name:WHEATLEY, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:WHEATLEY
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 1:4465 S 900 E STE 150
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3944
Mailing Address - Country:US
Mailing Address - Phone:435-248-2089
Mailing Address - Fax:801-207-5104
Practice Address - Street 1:488 E WINCHESTER ST STE 240
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-7590
Practice Address - Country:US
Practice Address - Phone:435-248-2089
Practice Address - Fax:801-207-5104
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13330188-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health