Provider Demographics
NPI:1043883945
Name:BOWLAND, JULIANA
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:BOWLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 LANCASTER AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-1341
Mailing Address - Country:US
Mailing Address - Phone:410-443-6692
Mailing Address - Fax:
Practice Address - Street 1:1199 LANCASTER AVE STE 105
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1341
Practice Address - Country:US
Practice Address - Phone:410-443-6692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020084103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist