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General NPI Number Information
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NPI Number | 1558493627
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Entity Type | Individual
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Provider Name | JULIE A LEWELLYN LSW
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1800 MARKET ST
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City | LEWISBURG
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State | PA
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Zip | 17837-1236
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Country | US
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Telephone | 570-322-7873
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Fax | 570-322-8026
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Provider Business Mailing Address
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Address Line | 65 MICHAEL DR
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City | BLOOMSBURG
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State | PA
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Zip | 17815-8982
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Country | US
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Telephone | 570-322-7873
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Fax | 570-322-8026
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW012943L
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License Number State | PA
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