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Individual

MS. JULIE LYNN BAKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
435 W 4TH ST, WILLIAMSPORT, PA 17701-6001
(570) 322-7873
(570) 322-8026
Mailing address
PO BOX 93, NEW BERLIN, PA 17855-0093
(570) 966-7152
(570) 322-8026

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
SW124091
PA
1041C0700X
Clinical Social Worker
Primary
CW015726
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50070176
CAPITAL BLUE CROSS
PA
Enumeration date
06/09/2006
Last updated
09/21/2007
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