Doctor Name: | MS. JULIE KAY YAEKEL-BLACK ELK |
NPI Number: | 1487785069 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD LPCC |
License Number: | 3776-125 |
Business Practice Address: | 49659 State Line Rd Sandstone, MN - 550723032 |
Business Phone Number: | 2185901932 |
Business Fax Number: | |
Mailing Address: | 49659 State Line Rd, SANDSTONE |
State: | MN |
Postal Code: | 550723032 |
Phone Number: | 2185901932 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 06/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 3776-125 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |