Provider Demographics
NPI:1659580546
Name:NEMETH, JULIE LEAF (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LEAF
Last Name:NEMETH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S 25TH ST
Mailing Address - Street 2:#627
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-6002
Mailing Address - Country:US
Mailing Address - Phone:212-847-7755
Mailing Address - Fax:
Practice Address - Street 1:201 S 25TH ST
Practice Address - Street 2:#627
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6002
Practice Address - Country:US
Practice Address - Phone:215-847-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS15992103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling