Individual
JULIE L IWANICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
264 E BROAD ST, BETHLEHEM, PA 18018-6278
(610) 866-9311
(610) 882-2072
Mailing address
2570 CHERRY LN, APT E3, BETHLEHEM, PA 18015-9534
(203) 648-7152
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF000683
PA
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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