Provider Demographics
NPI:1083924393
Name:FLYNN, JULIA ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANNE
Last Name:FLYNN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ANNE
Other - Last Name:SNIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:407 E RUSSELL AVE STE A5
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-1242
Mailing Address - Country:US
Mailing Address - Phone:660-429-6678
Mailing Address - Fax:660-429-6672
Practice Address - Street 1:407 E RUSSELL AVE STE A5
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-1242
Practice Address - Country:US
Practice Address - Phone:660-429-6678
Practice Address - Fax:660-429-6672
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008003017101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional