Provider Demographics
NPI:1366140253
Name:WILSON, JULIA CLAIRE
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:CLAIRE
Last Name:WILSON
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 1:1671 CITRON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2511
Mailing Address - Country:US
Mailing Address - Phone:973-287-9316
Mailing Address - Fax:
Practice Address - Street 1:330 ULUNIU ST STE 103
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2541
Practice Address - Country:US
Practice Address - Phone:808-489-3548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician