Provider Demographics
NPI:1902005671
Name:CANN, JULIA MARIE (MS)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIE
Last Name:CANN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 WENDWOOD LN
Mailing Address - Street 2:APT 309
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4184
Mailing Address - Country:US
Mailing Address - Phone:704-956-8593
Mailing Address - Fax:
Practice Address - Street 1:3720 WENDWOOD LANE
Practice Address - Street 2:APT 309
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4184
Practice Address - Country:US
Practice Address - Phone:704-956-8593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8668235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist