Healthcare Provider Details

I. General information

NPI: 1518889260
Provider Name (Legal Business Name): JULIA AUDE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12511 152ND AVE
GRAND HAVEN MI
49417-8527
US

IV. Provider business mailing address

12511 152ND AVE
GRAND HAVEN MI
49417-8527
US

V. Phone/Fax

Practice location:
  • Phone: 616-844-0906
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: