Provider Demographics
NPI:1033160023
Name:FAUBION, JULIE HALL (MSR, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:HALL
Last Name:FAUBION
Suffix:
Gender:F
Credentials:MSR, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 DEEP WATER DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7431
Mailing Address - Country:US
Mailing Address - Phone:843-209-3457
Mailing Address - Fax:843-849-6440
Practice Address - Street 1:1295 DEEP WATER DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7431
Practice Address - Country:US
Practice Address - Phone:843-209-3457
Practice Address - Fax:843-849-6440
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3166235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0562Medicaid