Healthcare Provider Details

I. General information

NPI: 1699157008
Provider Name (Legal Business Name): JULIE HARRISON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 E LAUREL RD STE 1100
STRATFORD NJ
08084-1354
US

IV. Provider business mailing address

42 E LAUREL RD STE 1100
STRATFORD NJ
08084-1354
US

V. Phone/Fax

Practice location:
  • Phone: 856-566-7036
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00712900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: