Provider Demographics
NPI:1225256423
Name:METTER, JULIAN B (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:B
Last Name:METTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4623
Mailing Address - Country:US
Mailing Address - Phone:814-231-2600
Mailing Address - Fax:
Practice Address - Street 1:313 LOGAN AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4623
Practice Address - Country:US
Practice Address - Phone:814-231-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-004700-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1492107Medicaid
PA435881Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER