Provider Demographics
NPI:1285232132
Name:SHOEMAKE, JULIE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:SHOEMAKE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 W 110TH ST STE 330
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1501
Mailing Address - Country:US
Mailing Address - Phone:913-521-9090
Mailing Address - Fax:913-521-9955
Practice Address - Street 1:458 NE 291 HWY
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-2501
Practice Address - Country:US
Practice Address - Phone:816-507-8885
Practice Address - Fax:816-533-4344
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4666235Z00000X
MO2020021627235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist