Provider Demographics
NPI:1073975876
Name:JULIAN, CARA LYNN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:LYNN
Last Name:JULIAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 WRIGHTSVILLE AVE
Mailing Address - Street 2:SUITE 20
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-8441
Mailing Address - Country:US
Mailing Address - Phone:910-799-0303
Mailing Address - Fax:
Practice Address - Street 1:3807 WRIGHTSVILLE AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8441
Practice Address - Country:US
Practice Address - Phone:910-799-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11817235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11817OtherNORTH CAROLINA STATE LICENSURE