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General NPI Number Information
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NPI Number | 1205914488
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Entity Type | Individual
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Provider Name | JULIANNE S BULAU MSW LICSW
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 203 W CLARK ST FREEBORN COUNTY MENTAL HEALTH CENTER
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City | ALBERT LEA
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State | MN
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Zip | 56007
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Country | US
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Telephone | 507-377-5400
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Fax | 507-377-5505
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Provider Business Mailing Address
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Address Line | 1923 WILBY RD
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City | ALBERT LEA
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State | MN
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Zip | 56007
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Country | US
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Telephone | 507-377-5446
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Fax | 507-377-5505
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14267
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License Number State | MN
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