Provider Demographics
NPI:1780223826
Name:LEPAGE, JULIE NICOLE (ATC)
Entity type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:NICOLE
Last Name:LEPAGE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LOCKELAND RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-3341
Mailing Address - Country:US
Mailing Address - Phone:408-656-8802
Mailing Address - Fax:
Practice Address - Street 1:100 SAINT ANSELM DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-1308
Practice Address - Country:US
Practice Address - Phone:603-641-7807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31952255A2300X
NH13492255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer