Healthcare Provider Details

I. General information

NPI: 1033020128
Provider Name (Legal Business Name): JULIANA HARROLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W GREENWAY ST
DERBY KS
67037-2641
US

IV. Provider business mailing address

2405 PEMBROKE CT
AUGUSTA KS
67010-2273
US

V. Phone/Fax

Practice location:
  • Phone: 316-253-8767
  • Fax: 316-288-2055
Mailing address:
  • Phone: 316-209-9277
  • Fax: 316-288-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: