Provider Demographics
NPI:1346629870
Name:CUBBEDGE, JULIE FAITH (HAS, BC-HIS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:FAITH
Last Name:CUBBEDGE
Suffix:
Gender:F
Credentials:HAS, BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-5504
Mailing Address - Country:US
Mailing Address - Phone:727-343-3019
Mailing Address - Fax:352-351-4522
Practice Address - Street 1:1430 66TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-5504
Practice Address - Country:US
Practice Address - Phone:727-343-3019
Practice Address - Fax:352-351-4522
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS 5079237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist