Provider Demographics
NPI:1255861506
Name:PETERS, JULIE A (HAS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:PETERS
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7536 SLATE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3156
Mailing Address - Country:US
Mailing Address - Phone:614-755-5125
Mailing Address - Fax:614-755-5129
Practice Address - Street 1:7536 SLATE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3156
Practice Address - Country:US
Practice Address - Phone:614-755-5125
Practice Address - Fax:614-755-5129
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03122237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist