Provider Demographics
NPI:1730536418
Name:CAVALLARIO, JULIE M (PHD, LAT, ATC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:M
Last Name:CAVALLARIO
Suffix:
Gender:F
Credentials:PHD, LAT, ATC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:M
Other - Last Name:WHITEHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:6850 AUSTIN CENTER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3184
Mailing Address - Country:US
Mailing Address - Phone:512-733-9700
Mailing Address - Fax:
Practice Address - Street 1:2134 A HEALTH SCIENCES BUILDING OLD DOMINION UNIVERSITY
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23529-6435
Practice Address - Country:US
Practice Address - Phone:757-683-4351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260006892255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer