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NPI Code Detail

MEDICARE: MRS. JULIANNA J. ANDERSON CT

MEDICARE: MRS. JULIANNA J. ANDERSON CT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE.2606888OH

General Provider Information

NPI Number : 1629711866
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIANNA J. ANDERSON CT
Provider Business Mailing Address
First Line : 1745 HARVARD BLVD
Second Line :
City : DAYTON
State : OH
Zip : 45406-4538
Country : US
Telephone Number : 937-815-7538
Fax Number :
Provider Business Practice Location Address
First Line : 3095 KETTERING BLVD
Second Line :
City : MORAINE
State : OH
Zip : 45439-1983
Country : US
Telephone Number : 937-293-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2022
Last Update Date : 04/06/2026

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