Healthcare Provider Details

I. General information

NPI: 1508919994
Provider Name (Legal Business Name): JULIE LYNN RASMUSSEN MA, LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 FAST ICE DR
MIDLAND MI
48642-6167
US

IV. Provider business mailing address

1222 SILVER RIDGE CT
GREENVILLE MI
48838-8184
US

V. Phone/Fax

Practice location:
  • Phone: 989-631-2320
  • Fax: 989-631-9903
Mailing address:
  • Phone: 616-302-0853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6361001189
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: