| Doctor Name: | MRS. JULIE ANN BRUSAW |
| NPI Number: | 1053494443 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA LCPC LMFT |
| License Number: | LCPC-2639 |
| Business Practice Address: | 1035 Baldy Mountain Rd Sandpoint, ID - 838649250 |
| Business Phone Number: | 2082559277 |
| Business Fax Number: | 2082551254 |
| Mailing Address: | 10561 Sagle Rd, SAGLE |
| State: | ID |
| Postal Code: | 838608836 |
| Phone Number: | 2082559277 |
| Fax Number: | 2082551254 |
| NPI Enumeration Date: | 10/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LCPC-2639 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |