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General NPI Number Information
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NPI Number | 1790489409
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Entity Type | Individual
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Provider Name | JULIA BURTON GOTTHOLD MA, ATR-BC, LPC
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Gender | Female
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 482 NORRISTOWN RD STE 114
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City | BLUE BELL
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State | PA
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Zip | 19422-2361
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Country | US
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Telephone | 610-888-1132
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Fax |
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Provider Business Mailing Address
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Address Line | 101 S 7TH ST
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City | NORTH WALES
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State | PA
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Zip | 19454-2816
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Country | US
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Telephone | 610-888-1132
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC015372
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License Number State | PA
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