Provider Demographics
NPI:1164629481
Name:JUDKINS-GIFFIN, JULIE ELAINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ELAINE
Last Name:JUDKINS-GIFFIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 OAK HILLS DR
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-7744
Mailing Address - Country:US
Mailing Address - Phone:931-454-2434
Mailing Address - Fax:931-455-6308
Practice Address - Street 1:1805 NORTH JACKSON STREET SUITES 2 &3
Practice Address - Street 2:JACKSON MEDICAL PLAZA
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388
Practice Address - Country:US
Practice Address - Phone:931-393-7964
Practice Address - Fax:931-455-6308
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1946235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist