Provider Demographics
NPI:1720419120
Name:CENTRELLA, JULIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:CENTRELLA
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 1:1005 W 9TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1202
Mailing Address - Country:US
Mailing Address - Phone:484-685-0965
Mailing Address - Fax:
Practice Address - Street 1:1005 W 9TH AVE STE B
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1202
Practice Address - Country:US
Practice Address - Phone:484-685-0965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017493103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist