Provider Demographics
NPI:1962114397
Name:JULIUS, TISA MARCIA
Entity type:Individual
Prefix:
First Name:TISA
Middle Name:MARCIA
Last Name:JULIUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2053 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1807
Mailing Address - Country:US
Mailing Address - Phone:513-328-2865
Mailing Address - Fax:
Practice Address - Street 1:2053 4TH AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1807
Practice Address - Country:US
Practice Address - Phone:513-328-2865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health