Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP2500X | Professional Counselor |
NPI | 1003947078 |
---|---|
Provider Name | Ms. Julie Juszkiewicz |
First Address | Fairbanks, AK 99707-2761 |
Second Address | Fairbanks, AK 99701-6039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 09/10/2008 |