| Anew Julie Riddle Msw Licsw Pllc | |
|
117 N Washington St Ste C Grand Forks ND 58203-3450 | |
| (701) 248-6040 | |
| Not Available |
| Full Name | Anew Julie Riddle Msw Licsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 117 N Washington St Ste C, Grand Forks, North Dakota |
| Authorized Official Name and Position | Julie Riddle (OWNER) |
| Authorized Official Contact | 7012486040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anew Julie Riddle Msw Licsw Pllc 117 N Washington St Ste C Grand Forks ND 58203-3450 Ph: () - | Anew Julie Riddle Msw Licsw Pllc 117 N Washington St Ste C Grand Forks ND 58203-3450 Ph: (701) 248-6040 |
| NPI Number | 1932768645 |
|---|---|
| Provider Enumeration Date | 06/07/2019 |
| Last Update Date | 06/07/2019 |
| Medicare PECOS PAC ID | 4183950280 |
|---|---|
| Medicare Enrollment ID | O20190726002689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932768645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Julie A Riddle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669662284 PECOS PAC ID: 8123119633 Enrollment ID: I20070813000011 |
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