Doctor Name: | JULIE DANDA |
NPI Number: | 1538434238 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., C.P.R.P. |
License Number: | |
Business Practice Address: | 50 2nd Ave S Waite Park, MN - 563871322 |
Business Phone Number: | 3206549527 |
Business Fax Number: | 3206549542 |
Mailing Address: | 50 2nd Ave S, WAITE PARK |
State: | MN |
Postal Code: | 563871322 |
Phone Number: | 3206549527 |
Fax Number: | 3206549542 |
NPI Enumeration Date: | 03/13/2012 |
NPI Last Update Date: | 03/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |