MEDICARE: JULIE GREENBERG LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MF000554	PA

General Provider Information

NPI Number	:	1326431909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE GREENBERG LMFT

Provider Business Mailing Address
First Line	:	6445 GREENE ST.
Second Line	:	B202
City	:	PHILA
State	:	PA
Zip	:	19119
Country	:	US
Telephone Number	:	215-843-9592
Fax Number	:

Provider Business Practice Location Address
First Line	:	6445 GREENE ST.
Second Line	:	B202
City	:	PHILA
State	:	PA
Zip	:	19119
Country	:	US
Telephone Number	:	215-843-9592
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2015
Last Update Date	:	03/06/2015

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