Healthcare Provider Details

I. General information

NPI: 1336606797
Provider Name (Legal Business Name): JULIE MARIE HEINLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2019
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 WOOD ST
MOUNT JOY PA
17552-1925
US

IV. Provider business mailing address

929 WOOD ST
MOUNT JOY PA
17552-1925
US

V. Phone/Fax

Practice location:
  • Phone: 970-678-6458
  • Fax:
Mailing address:
  • Phone: 970-678-6458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0009927523
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: