Doctor Name: | JULI DRAGISIC |
NPI Number: | 1033574777 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 180009994 |
Business Practice Address: | 2301 Glenwood Ave Joliet, IL - 604355481 |
Business Phone Number: | 8157308221 |
Business Fax Number: | |
Mailing Address: | 2301 Glenwood Ave, JOLIET |
State: | IL |
Postal Code: | 604355481 |
Phone Number: | 8157308221 |
Fax Number: | |
NPI Enumeration Date: | 12/23/2015 |
NPI Last Update Date: | 12/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 180009994 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |