Healthcare Provider Details

I. General information

NPI: 1821424532
Provider Name (Legal Business Name): JULIA VAHLSING PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2013
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 MONUMENT RD
PHILADELPHIA PA
19131
US

IV. Provider business mailing address

1405 DELMONT AVE
HAVERTOWN PA
19083-2627
US

V. Phone/Fax

Practice location:
  • Phone: 215-877-2000
  • Fax:
Mailing address:
  • Phone: 610-745-0649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS018152
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: