Provider Demographics
NPI:1467818872
Name:FAHRNEY, JULIA (AUD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:FAHRNEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 IRVIN CT STE 140
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-5406
Mailing Address - Country:US
Mailing Address - Phone:404-297-4230
Mailing Address - Fax:404-297-4252
Practice Address - Street 1:484 IRVIN CT STE 140
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-5406
Practice Address - Country:US
Practice Address - Phone:404-297-4230
Practice Address - Fax:404-297-4252
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD004015231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003175485AMedicaid
GA003175485AMedicaid