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Individual

JULIANA WARD SUPPA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
891 BELSLY BLVD, MOORHEAD, MN 56560-5055
(218) 287-4338
(218) 287-5928
Mailing address
891 BELSLY BLVD, MOORHEAD, MN 56560-5055
(218) 287-4338
(218) 287-5928

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-37173
ND
174400000X
Specialist

Other

Enumeration date
07/18/2017
Last updated
07/21/2022
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