Provider Demographics
NPI:1487309506
Name:JULOT, KASANDRA MARIE
Entity type:Individual
Prefix:MRS
First Name:KASANDRA
Middle Name:MARIE
Last Name:JULOT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KASANDRA
Other - Middle Name:MARIE
Other - Last Name:PENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2719 W THARPE ST APT 35
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-8659
Mailing Address - Country:US
Mailing Address - Phone:786-644-9807
Mailing Address - Fax:
Practice Address - Street 1:2719 W THARPE ST APT 35
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-8659
Practice Address - Country:US
Practice Address - Phone:786-644-9807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician