Provider Demographics
NPI:1356479976
Name:WITTEN, JULIE (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:WITTEN
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 LINWOOD AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-4426
Mailing Address - Country:US
Mailing Address - Phone:404-879-0128
Mailing Address - Fax:
Practice Address - Street 1:1441 CLIFTON ROAD, N.E.
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30032
Practice Address - Country:US
Practice Address - Phone:404-712-7249
Practice Address - Fax:404-712-5974
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006079235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist