Individual
JULI A BARDSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
501 N 16TH ST, SUITE 108, PAYETTE, ID 83661-2781
(208) 642-2600
(208) 642-6164
Mailing address
3655 S JOHNS AVE, EMMETT, ID 83617-9009
(208) 365-1637
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806586200
—
ID
Enumeration date
12/23/2009
Last updated
12/23/2009
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