Provider Demographics
NPI:1437508629
Name:PANCHAMSINGH-BARAKAT, JULIE A (EDD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:PANCHAMSINGH-BARAKAT
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:366 TRUMAN HWY
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1025
Mailing Address - Country:US
Mailing Address - Phone:617-851-1759
Mailing Address - Fax:
Practice Address - Street 1:400-, 402 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368
Practice Address - Country:US
Practice Address - Phone:781-986-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20324261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical