Individual
JULIE ANN MOYLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LADC, LPCC
Contact information
Practice address
116 CHESTNUT ST E # 150, STILLWATER, MN 55082-5116
(651) 494-4583
Mailing address
204 CHERRY ST W APT 3, STILLWATER, MN 55082-6771
(651) 494-4583
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304182
MN
101YM0800X
Mental Health Counselor
01861
MN
101YM0800X
Mental Health Counselor
Primary
1896
MN
Other
Enumeration date
08/03/2017
Last updated
09/13/2018
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