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NPI Code Detail

MEDICARE: JULIA GANNON

MEDICARE: JULIA GANNON
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1497341986
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA GANNON
Provider Business Mailing Address
First Line : 429 WASHINGTON AVE
Second Line :
City : BRIDGEVILLE
State : PA
Zip : 15017-2350
Country : US
Telephone Number : 412-319-7371
Fax Number :
Provider Business Practice Location Address
First Line : 429 WASHINGTON AVE
Second Line :
City : BRIDGEVILLE
State : PA
Zip : 15017-2350
Country : US
Telephone Number : 412-319-7371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2020
Last Update Date : 03/03/2026

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Directions to “ JULIA GANNON ” Practice Location

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