Individual
JULIE ANN PRUDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
524 W WAYFARER CT, APPLETON, WI 54913-6865
(920) 851-4041
Mailing address
524 W WAYFARER CT, APPLETON, WI 54913-6865
(920) 851-4041
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1767-125
WI
Other
Enumeration date
01/21/2019
Last updated
01/21/2019
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