Provider Demographics
NPI:1720830185
Name:CAFFREY, JULIAN ALEXANDRA (PSYD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:ALEXANDRA
Last Name:CAFFREY
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 1:2132 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-4810
Mailing Address - Country:US
Mailing Address - Phone:470-605-4289
Mailing Address - Fax:
Practice Address - Street 1:2132 S 12TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-4810
Practice Address - Country:US
Practice Address - Phone:470-605-4289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020117103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical