Provider Demographics
NPI:1275274086
Name:AURA, JULIET
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:AURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 LEXINGTON RD UNIT 109
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2973
Mailing Address - Country:US
Mailing Address - Phone:936-553-8592
Mailing Address - Fax:
Practice Address - Street 1:2900 W BROADWAY STE 320
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-1280
Practice Address - Country:US
Practice Address - Phone:502-852-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool