Provider Demographics
NPI:1982833364
Name:CARRUS, JULIANA PABON (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:PABON
Last Name:CARRUS
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 1:8536 CROW DR
Mailing Address - Street 2:STE 240
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1986
Mailing Address - Country:US
Mailing Address - Phone:440-498-1100
Mailing Address - Fax:
Practice Address - Street 1:8536 CROW DR
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-1900
Practice Address - Country:US
Practice Address - Phone:330-888-9596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12046784103K00000X
OHSP8347235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty