Provider Demographics
NPI:1396219119
Name:SAUNDERS, JULIA FREDA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:FREDA
Last Name:SAUNDERS
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 1:2325 HANOVER DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-0450
Mailing Address - Country:US
Mailing Address - Phone:704-282-4758
Mailing Address - Fax:704-282-4683
Practice Address - Street 1:2325 HANOVER DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-0450
Practice Address - Country:US
Practice Address - Phone:704-282-4758
Practice Address - Fax:704-282-4683
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17280225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty