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General NPI Number Information
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NPI Number | 1841403151
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Entity Type | Individual
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Provider Name | ANDREA BETH WELLER JUNKER PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 560 RISING SUN LN
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City | MILLERSBURG
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State | PA
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Zip | 17061-1243
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Country | US
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Telephone | 717-829-5507
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Fax |
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Provider Business Mailing Address
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Address Line | 560 RISING SUN RD
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City | MILLERSBURG
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State | PA
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Zip | 17061
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Country | US
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Telephone | 717-829-5507
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS017081
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License Number State | PA
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