Provider Demographics
NPI:1902985054
Name:JULIA, ANNA MARIE (LISW)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:MARIE
Last Name:JULIA
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CASTERTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1517
Mailing Address - Country:US
Mailing Address - Phone:330-940-3441
Mailing Address - Fax:330-940-3417
Practice Address - Street 1:3033 STATE ROAD
Practice Address - Street 2:SUITE 104
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-3614
Practice Address - Country:US
Practice Address - Phone:330-940-3441
Practice Address - Fax:330-940-3417
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00060291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
JUSW1005ZMedicare ID - Type Unspecified
R72165Medicare UPIN