Doctor Name: | JULIE ANN CARLSON |
NPI Number: | 1205992211 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW, LMHC, CADC |
License Number: | 40067 |
Business Practice Address: | 4700 93rd St Urbandale, IA - 503226222 |
Business Phone Number: | 5153211300 |
Business Fax Number: | 5152855657 |
Mailing Address: | 4700 93rd St, URBANDALE |
State: | IA |
Postal Code: | 503226222 |
Phone Number: | 5153211300 |
Fax Number: | 5152855657 |
NPI Enumeration Date: | 12/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 40067 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |