Provider Demographics
NPI:1366586679
Name:HERTZ, JULIANNE (ATR-BC, LMHC)
Entity type:Individual
Prefix:MS
First Name:JULIANNE
Middle Name:
Last Name:HERTZ
Suffix:
Gender:F
Credentials:ATR-BC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3361
Mailing Address - Country:US
Mailing Address - Phone:617-926-1344
Mailing Address - Fax:617-926-1344
Practice Address - Street 1:62 LOWELL AVE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-3361
Practice Address - Country:US
Practice Address - Phone:617-926-1344
Practice Address - Fax:617-926-1344
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3700221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist