Provider Demographics
NPI:1760711402
Name:MUELLER, JULIE HONORE (CMT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:HONORE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1432
Mailing Address - Country:US
Mailing Address - Phone:612-205-4453
Mailing Address - Fax:
Practice Address - Street 1:3921 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1432
Practice Address - Country:US
Practice Address - Phone:612-205-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNNO LICENSE REQUIRED171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor