| Doctor Name: | JULIE IVERSON |
| NPI Number: | 1730562919 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 711 6th Ave Ne Isanti, MN - 550403207 |
| Business Phone Number: | 7634445567 |
| Business Fax Number: | |
| Mailing Address: | 19877 Jackson St Ne, EAST BETHEL |
| State: | MN |
| Postal Code: | 550119580 |
| Phone Number: | 6126366127 |
| Fax Number: | |
| NPI Enumeration Date: | 07/07/2015 |
| NPI Last Update Date: | 07/07/2015 |
| 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: | |