Individual
JULIE ANN HANENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
150 10TH ST NW STE 2, MILACA, MN 56353-1737
(320) 983-2335
(651) 342-8029
Mailing address
150 10TH ST NW STE 2, MILACA, MN 56353-1737
(320) 983-2335
(320) 983-2330
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15603
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
632410000
MHCP PROVIDER NUMBER
MN
Enumeration date
05/01/2007
Last updated
03/07/2024
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