Provider Demographics
NPI:1407213259
Name:MENK, JULIE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MENK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 COVERED BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-6101
Mailing Address - Country:US
Mailing Address - Phone:256-390-1692
Mailing Address - Fax:
Practice Address - Street 1:68 N VALLEY AVE
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35961-3330
Practice Address - Country:US
Practice Address - Phone:256-524-2117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1742235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist