Provider Demographics
NPI:1114547403
Name:WOSKA, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:WOSKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:CARMEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 CRAWFORD PL STE 260
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3965
Mailing Address - Country:US
Mailing Address - Phone:856-628-1686
Mailing Address - Fax:
Practice Address - Street 1:1000 CRAWFORD PL STE 260
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3965
Practice Address - Country:US
Practice Address - Phone:856-628-1686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-19-10247106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst