Provider Demographics
NPI:1396045654
Name:STEVENS, JULIE L (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:L
Other - Last Name:FEELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:21 HAMPSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2134
Mailing Address - Country:US
Mailing Address - Phone:781-913-2030
Mailing Address - Fax:
Practice Address - Street 1:21 HAMPSHIRE RD
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2134
Practice Address - Country:US
Practice Address - Phone:781-913-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP-8138-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist