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General NPI Number Information
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NPI Number | 1174097422
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Entity Type | Individual
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Provider Name | JULIE LYNETTE DRAVIS LPC, MAC, CDCI
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Gender | Female
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 508 S WILLOW ST STE D
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City | KENAI
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State | AK
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Zip | 99611-6940
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Country | US
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Telephone | 907-252-6728
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 903
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City | KENAI
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State | AK
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Zip | 99611-0903
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Country | US
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Telephone | 907-252-6728
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 491
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License Number State | AK
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