MEDICARE: JULIA LOUISE SCHROEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1114228145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA LOUISE SCHROEN

Provider Business Mailing Address
First Line	:	2426 STATE ROUTE 11
Second Line	:	SUITE A
City	:	NORTH BANGOR
State	:	NY
Zip	:	12966-2747
Country	:	US
Telephone Number	:	518-521-8869
Fax Number	:

Provider Business Practice Location Address
First Line	:	2426 STATE ROUTE 11
Second Line	:	SUITE A
City	:	NORTH BANGOR
State	:	NY
Zip	:	12966-2747
Country	:	US
Telephone Number	:	518-521-8869
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2010
Last Update Date	:	04/30/2017

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