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General NPI Number Information
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NPI Number | 1720745540
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Entity Type | Organization
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Legal Business Name | JULIE MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 18 CAMPUS BLVD STE 100
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-3240
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Country | US
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Telephone | 267-276-3680
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Fax |
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Provider Business Mailing Address
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Address Line | 18 CAMPUS BLVD STE 100
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-3240
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Country | US
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Telephone | 267-276-3680
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JULIANA OMILE
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Credential | PMHNP
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Telephone | 267-276-3680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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