Doctor Name: | JULIE ANN HANENBURG |
NPI Number: | 1710108790 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 15603 |
Business Practice Address: | 160 3rd Ave Nw Milaca, MN - 563531555 |
Business Phone Number: | 3209832335 |
Business Fax Number: | 3209832330 |
Mailing Address: | 160 3rd Ave Nw, MILACA |
State: | MN |
Postal Code: | 563531555 |
Phone Number: | 3209832335 |
Fax Number: | 3209832330 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 05/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 15603 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |