Healthcare Provider Details

I. General information

NPI: 1477393551
Provider Name (Legal Business Name): JULIE OBRIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 W STATE ST
NEW CASTLE PA
16101-1240
US

IV. Provider business mailing address

2010 W STATE ST
NEW CASTLE PA
16101-1240
US

V. Phone/Fax

Practice location:
  • Phone: 724-674-0409
  • Fax:
Mailing address:
  • Phone: 724-658-4688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: