MEDICARE: JULIANNE POULIN

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1760330773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNE POULIN

Provider Business Mailing Address
First Line	:	1561 S 12TH ST W APT B
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-4856
Country	:	US
Telephone Number	:	508-505-6533
Fax Number	:

Provider Business Practice Location Address
First Line	:	1561 S 12TH ST W APT B
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-4856
Country	:	US
Telephone Number	:	508-505-6533
Fax Number	:

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

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “ JULIANNE POULIN ” Practice Location

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