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Individual
JULIE M WATERDU
Active
Individual
JULIE M WATERDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
858-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568770774
—
WI
Enumeration date
09/22/2010
Last updated
01/08/2021
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