Provider Demographics
NPI:1841065638
Name:ANDERSON DENNIS, JULIE
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:ANDERSON DENNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 ALEXANDER WAY
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-8696
Mailing Address - Country:US
Mailing Address - Phone:926-683-2399
Mailing Address - Fax:
Practice Address - Street 1:302 ALEXANDER WAY
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-8696
Practice Address - Country:US
Practice Address - Phone:926-683-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health