Provider Demographics
NPI:1952020620
Name:MARVER, JULIA ELIZABETH (PHD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ELIZABETH
Last Name:MARVER
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 1:265-16 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11004
Mailing Address - Country:US
Mailing Address - Phone:718-470-8052
Mailing Address - Fax:
Practice Address - Street 1:265-16 74TH AVENUE
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004
Practice Address - Country:US
Practice Address - Phone:718-470-8052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025129103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical