Individual
BIANCA ST JULIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4720 E COTTON GIN LOOP, PHOENIX, AZ 85040-4823
(877) 279-0891
Mailing address
5322 AVENUE J, HOUSTON, TX 77011-2108
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2102803
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000000
—
TX
Enumeration date
07/03/2013
Last updated
01/14/2021
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