Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC3717 | TN |
N | 101YS0200X | School Counselor |
NPI | 1114261161 |
---|---|
Provider Name | Julie Ann Raulie |
First Address | Athens, TN 37303-6281 |
Second Address | Athens, TN 37303-6281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2012 |
Last Update Date | 17/03/2018 |