Provider Demographics
NPI:1154149631
Name:SANTOS, JULIA MAINARDA (MS)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MAINARDA
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 SILVANO DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8656
Mailing Address - Country:US
Mailing Address - Phone:484-619-0669
Mailing Address - Fax:
Practice Address - Street 1:1536 FORDING ISLAND RD STE 105
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-1144
Practice Address - Country:US
Practice Address - Phone:843-837-2080
Practice Address - Fax:843-837-2081
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8950235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist