Provider Demographics
NPI:1194352294
Name:HARDY, JULIE M (PROFESSIONAL COUNSEL)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:HARDY
Suffix:
Gender:F
Credentials:PROFESSIONAL COUNSEL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315S COUNTY ROAD 442
Mailing Address - Street 2:
Mailing Address - City:COOKS
Mailing Address - State:MI
Mailing Address - Zip Code:49817-9740
Mailing Address - Country:US
Mailing Address - Phone:906-286-0876
Mailing Address - Fax:
Practice Address - Street 1:7870W US HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:MANISTIQUE
Practice Address - State:MI
Practice Address - Zip Code:49854-8992
Practice Address - Country:US
Practice Address - Phone:906-341-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017934101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional