Provider Demographics
NPI:1407401540
Name:ATTAWAY, JULIA BROOKE
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:BROOKE
Last Name:ATTAWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 CRUMP RD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-9279
Mailing Address - Country:US
Mailing Address - Phone:863-207-5121
Mailing Address - Fax:
Practice Address - Street 1:2020 W LAKE PARKER DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-5005
Practice Address - Country:US
Practice Address - Phone:863-682-7580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist