Individual
JULIE A GORDON-DUECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
964 ISABEL DR, LEBANON, PA 17042-7482
(717) 274-9777
(717) 274-9815
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS007868L
PA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS007868L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103352242
—
PA
01
—
11824245
CAQH
—
01
—
PS007868L
STATE LICENSE
PA
Enumeration date
06/08/2007
Last updated
10/28/2024
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