Provider Demographics
NPI:1922823061
Name:HOLGUIN, JULIANNA MICHELLE (MS, PLMFT, LMFT)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:MICHELLE
Last Name:HOLGUIN
Suffix:
Gender:F
Credentials:MS, PLMFT, LMFT
Other - Prefix:
Other - First Name:JULIANNA
Other - Middle Name:
Other - Last Name:WISNESKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, PLMFT, LMFT
Mailing Address - Street 1:7546 STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3600
Mailing Address - Country:US
Mailing Address - Phone:816-457-2950
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 8619
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-0619
Practice Address - Country:US
Practice Address - Phone:816-605-7144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024001424106H00000X
KS03672106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist