# JULIE M WATERDU

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568770774
- **Gender:** F
- **Credential:** LMFT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 858-124 | WI | Yes |

## Other

- **Enumeration date:** 09/22/2010
- **Last updated:** 01/08/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1568770774 | — | WI |