Individual
JULIE IVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433-2638
(763) 767-3350
Mailing address
19877 JACKSON ST NE, EAST BETHEL, MN 55011-9580
(612) 636-6127
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CC02411
MN
Other
Enumeration date
07/07/2015
Last updated
03/27/2020
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