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Individual

JULIE SIGLER EDMUNDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS.,LPC.,CSAC,ICS

Contact information

Practice address
1100 LAKE VIEW DR, PREMIER RECOVERY, WAUSAU, WI 54403-6785
(715) 213-3503
Mailing address
5820 PAUL REVERE CT, WISCONSIN RAPIDS, WI 54494-3490
(715) 213-3503

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10668
WI
101YP2500X
Professional Counselor
4416-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39381100
WI
Enumeration date
12/13/2006
Last updated
09/09/2010
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