Provider Demographics
NPI:1841226248
Name:WIERNIK, JULIE LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LYNN
Last Name:WIERNIK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11122 WURZBACH RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2573
Mailing Address - Country:US
Mailing Address - Phone:210-845-0522
Mailing Address - Fax:210-558-0410
Practice Address - Street 1:11122 WURZBACH RD
Practice Address - Street 2:SUITE 302
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2573
Practice Address - Country:US
Practice Address - Phone:210-845-0522
Practice Address - Fax:210-558-0410
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32920103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical