Provider Demographics
NPI:1811795172
Name:GILLIGAN, JULIE ANN (MT-BC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:GILLIGAN
Suffix:
Gender:
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WAR ADMIRAL LN
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5238
Mailing Address - Country:US
Mailing Address - Phone:484-680-5246
Mailing Address - Fax:
Practice Address - Street 1:416 QUEEN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3021
Practice Address - Country:US
Practice Address - Phone:215-320-2625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist