Basic Information
| Provider Information | |||||||||
| NPI: | 1013950849 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEHNER | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3117 ASHWOOD DR | ||||||||
| Address2: | |||||||||
| City: | URBANDALE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503224115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5155773866 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6200 AURORA AVE | ||||||||
| Address2: | STE 302W | ||||||||
| City: | URBANDALE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503222800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5153310303 | ||||||||
| FaxNumber: | 5153319086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 05/12/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 06179 | IA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.