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General NPI Number Information
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NPI Number | 1942616503
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Entity Type | Organization
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Legal Business Name | JULIA FERRENCE
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 2305 FAIRMOUNT AVENUE
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City | PHILADELPHIA
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State | PA
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Zip | 19130
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Country | US
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Telephone | 215-920-2508
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Fax |
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Provider Business Mailing Address
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Address Line | 882 N. MYRTLEWOOD ST.
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City | PHILADELPHIA
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State | PA
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Zip | 19130
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Country | US
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Telephone | 215-920-2508
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. JULIA FERRENCE
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Credential | MSW, LCSW
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Telephone | 215-920-2508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW0175517
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License Number State | PA
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