MEDICARE: JULIE B MARINER

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	101YP2500X	Professional Counselor
2	101YP2500X	Professional Counselor	PC013440	PA

General Provider Information

NPI Number	:	1790357697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE B MARINER

Provider Business Mailing Address
First Line	:	221 OVERLOOK DR
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2657
Country	:	US
Telephone Number	:	724-255-6413
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 OVERLOOK DR
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2657
Country	:	US
Telephone Number	:	724-255-6413
Fax Number	:

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

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	07/05/2023

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Directions to “ JULIE B MARINER ” Practice Location

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