Healthcare Provider Details

I. General information

NPI: 1205196169
Provider Name (Legal Business Name): JULI GARLINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2012
Last Update Date: 05/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1726 S WASHINGTON ST STE 33A
GRAND FORKS ND
58201-6395
US

IV. Provider business mailing address

PO BOX 9859
FARGO ND
58106-9859
US

V. Phone/Fax

Practice location:
  • Phone: 701-746-4584
  • Fax:
Mailing address:
  • Phone: 701-451-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4672
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: