MEDICARE: JULIA PISANI

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
1	106S00000X	Behavior Technician		SC

General Provider Information

NPI Number	:	1356204010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA PISANI

Provider Business Mailing Address
First Line	:	3000 CYPRESS LAKE RD APT 5215
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-9051
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 CYPRESS LAKE RD APT 5215
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-9051
Country	:	US
Telephone Number	:	207-303-9479
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ JULIA PISANI ” Practice Location

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