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General NPI Number Information
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NPI Number | 1942826532
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Entity Type | Individual
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Provider Name | JULIE MARIE FLISS LPC
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Gender | Female
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 06/19/2020
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Provider Practice Location Address
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Address Line | N17W24340 RIVERWOOD DR
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City | WAUKESHA
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State | WI
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Zip | 53188-1142
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Country | US
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Telephone | 262-399-8954
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Fax |
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Provider Business Mailing Address
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Address Line | 8023 W NORTH AVE APT 1
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City | WAUWATOSA
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State | WI
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Zip | 53213-1697
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Country | US
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Telephone | 414-736-6567
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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 | 5732-125
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License Number State | WI
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