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Individual
JULIA MARIE VANDEMARK
Active
Individual
JULIA MARIE VANDEMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COUNSELOR TRAINEE
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
C.1700708
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074861
ODADAS
OH
01
—
0074946
ODMH
OH
01
—
01-0693
CARF
OH
01
—
H130910
PTAN GROUP
OH
Enumeration date
07/03/2018
Last updated
07/03/2018
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