Provider Demographics
NPI:1386867521
Name:ALZHEIMER, JULIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ALZHEIMER
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 1:7540 FLORENCE CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2894
Mailing Address - Country:US
Mailing Address - Phone:907-440-4416
Mailing Address - Fax:907-562-8262
Practice Address - Street 1:4325 LAUREL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5338
Practice Address - Country:US
Practice Address - Phone:907-440-4416
Practice Address - Fax:907-562-8262
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK162235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK74211Medicaid