Provider Demographics
NPI:1578393971
Name:JOHNSON, JULIA A
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:JOHNSON
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 1:198 OVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:LONG POND
Mailing Address - State:PA
Mailing Address - Zip Code:18334-7824
Mailing Address - Country:US
Mailing Address - Phone:347-944-7688
Mailing Address - Fax:
Practice Address - Street 1:198 OVERLAND DR
Practice Address - Street 2:
Practice Address - City:LONG POND
Practice Address - State:PA
Practice Address - Zip Code:18334-7824
Practice Address - Country:US
Practice Address - Phone:347-944-7688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker