Provider Demographics
NPI:1366561664
Name:PROCTOR, JULIE (LMHC)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:PROCTOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:112 PONDEROSA RD
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-8668
Mailing Address - Country:US
Mailing Address - Phone:206-234-9052
Mailing Address - Fax:
Practice Address - Street 1:23 S WENATCHEE AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2264
Practice Address - Country:US
Practice Address - Phone:206-234-9052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008771101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health