Provider Demographics
NPI:1366080939
Name:JULIAN, CATHERINE MARIE (CTRS)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:MARIE
Last Name:JULIAN
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 KAELEKU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-3011
Mailing Address - Country:US
Mailing Address - Phone:808-271-6972
Mailing Address - Fax:
Practice Address - Street 1:1190 KAELEKU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-3011
Practice Address - Country:US
Practice Address - Phone:808-271-6972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI51955225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist