Provider Demographics
NPI:1316739097
Name:DUNHAM, JULIA ELIZABETH (MED, BCBA, LBS)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ELIZABETH
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:MED, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 N HANCOCK ST UNIT 208
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-4574
Mailing Address - Country:US
Mailing Address - Phone:610-704-1054
Mailing Address - Fax:
Practice Address - Street 1:1059 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-1824
Practice Address - Country:US
Practice Address - Phone:610-704-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-24-72913103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst