Healthcare Provider Details

I. General information

NPI: 1336008440
Provider Name (Legal Business Name): JULIANA ANGELINE THRALL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 6TH ST E
SAINT PAUL MN
55101-4911
US

IV. Provider business mailing address

250 6TH ST E APT 634
SAINT PAUL MN
55101-1966
US

V. Phone/Fax

Practice location:
  • Phone: 651-273-3522
  • Fax:
Mailing address:
  • Phone: 651-273-3522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: JULIANA ANGELINE THRALL
Title or Position: OWNER
Credential: MPS, LPCC, ATR-BC
Phone: 207-671-4420