Doctor Name: | MS. JULIE BETH PORTNOY |
NPI Number: | 1104147917 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | |
Business Practice Address: | 323 Conshohocken State Rd Penn Valley, PA - 190721342 |
Business Phone Number: | 5415158166 |
Business Fax Number: | |
Mailing Address: | 323 Conshohocken State Rd, PENN VALLEY |
State: | PA |
Postal Code: | 190721342 |
Phone Number: | 5415158166 |
Fax Number: | |
NPI Enumeration Date: | 06/15/2010 |
NPI Last Update Date: | 11/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |