Provider Demographics
NPI:1366835852
Name:DAVIS, JULIE ANNE (MA,CCC/SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA,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:VANDERBILT BILL WILKERSON CTR
Mailing Address - Street 2:1215 21ST AVENUE SOUTH, SUITE 9211
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-8590
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:VANDERBILT BILL WILKERSON CTR
Practice Address - Street 2:1215 21ST AVENUE SOUTH, SUITE 9211
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-8590
Practice Address - Country:US
Practice Address - Phone:615-936-1561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3544235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist