Individual
MS. JULIE ANN CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
2353 RICE ST, SUITE 214, ROSEVILLE, MN 55113-3739
(651) 783-5656
(651) 483-1525
Mailing address
14275 PALM ST NW, ANDOVER, MN 55304-4172
(763) 862-6632
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
301162
MN
1041C0700X
Clinical Social Worker
Primary
11272
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01031200
PREFERRED ONE
MN
01
—
163T1CH
BLUE CROSS BLUE SHIELD
MN
05
—
444267900
—
MN
Enumeration date
07/11/2006
Last updated
04/26/2009
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