Provider Demographics
NPI:1598636151
Name:WILKISON, JULIAN IV
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:WILKISON
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 CANDLEMAKER DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-3703
Mailing Address - Country:US
Mailing Address - Phone:513-266-8573
Mailing Address - Fax:
Practice Address - Street 1:2217 CANDLEMAKER DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-3703
Practice Address - Country:US
Practice Address - Phone:513-266-8573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician