Provider Demographics
NPI:1275855405
Name:HENGST, JULIE ANN (CCC-SLP; PHD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:HENGST
Suffix:
Gender:F
Credentials:CCC-SLP; PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S 6TH ST
Mailing Address - Street 2:DEPT OF SPEECH & HEARING SCIENCE
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-6206
Mailing Address - Country:US
Mailing Address - Phone:217-244-6149
Mailing Address - Fax:
Practice Address - Street 1:901 S 6TH ST
Practice Address - Street 2:DEPT OF SPEECH & HEARING SCIENCE
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-6206
Practice Address - Country:US
Practice Address - Phone:217-244-6149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146004017235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist