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NPI Code Detail

MEDICARE: JULIANNA R SHALTRY MA, LPC, CAADC, NCC

MEDICARE: JULIANNA R SHALTRY MA, LPC, CAADC, NCC
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
1101YP2500XProfessional Counselor6401013241MI

General Provider Information

NPI Number : 1659623312
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIANNA R SHALTRY MA, LPC, CAADC, NCC
Provider Business Mailing Address
First Line : 311 HARRISON ST
Second Line :
City : GRAND LEDGE
State : MI
Zip : 48837-1577
Country : US
Telephone Number : 517-338-3090
Fax Number : 517-338-3090
Provider Business Practice Location Address
First Line : 311 HARRISON ST
Second Line :
City : GRAND LEDGE
State : MI
Zip : 48837-1577
Country : US
Telephone Number : 517-338-3090
Fax Number : 517-338-3090
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2012
Last Update Date : 06/06/2023

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