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Individual
JULIE ELAINE FANN
Active
Individual
JULIE ELAINE FANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LCMHC, NCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14088
NC
101YP2500X
Professional Counselor
14088
NC
101YP2500X
Professional Counselor
A14088
NC
Other
Enumeration date
07/31/2018
Last updated
03/17/2021
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