Provider Demographics
NPI:1073627097
Name:WOOD, JULIE FREEMAN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:FREEMAN
Last Name:WOOD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SIMON TRL
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9569
Mailing Address - Country:US
Mailing Address - Phone:828-243-0854
Mailing Address - Fax:828-254-5557
Practice Address - Street 1:143 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1815
Practice Address - Country:US
Practice Address - Phone:828-254-8889
Practice Address - Fax:828-254-8887
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6195235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC139KTOtherBCBSNC
NC7412458Medicaid