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Individual

MS. JULIETTE DENISE MINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Mailing address
5204 GLENWOOD DR, PINE HILL, NJ 08021-7625
(862) 216-0517

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
44SL05612500
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05578700
NJ

Other

Enumeration date
11/24/2010
Last updated
05/05/2015
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