Doctor Name: | MRS. JULIE L ROESKE |
NPI Number: | 1093148223 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 65 N Highway 101 Ste 204 Warrenton, OR - 971469371 |
Business Phone Number: | 5033250241 |
Business Fax Number: | |
Mailing Address: | 65 N Highway 101 Ste 204, WARRENTON |
State: | OR |
Postal Code: | 971469371 |
Phone Number: | 5033250241 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2013 |
NPI Last Update Date: | 05/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |