Healthcare Provider Details

I. General information

NPI: 1164863874
Provider Name (Legal Business Name): JULIE ANNE GLEDHILL MSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 CLARK ST
DES MOINES IA
50314-1964
US

IV. Provider business mailing address

2108 NW ASHTON LN UNIT 2
ANKENY IA
50023-7809
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-6536
  • Fax: 515-643-6598
Mailing address:
  • Phone: 515-643-6536
  • Fax: 515-643-6598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number008019
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: