Provider Demographics
NPI:1437861846
Name:PECK, JULIA (MS, CCC/SLP, IBCLC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:PECK
Suffix:
Gender:F
Credentials:MS, CCC/SLP, IBCLC
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:KROHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2101 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2013
Mailing Address - Country:US
Mailing Address - Phone:410-310-8349
Mailing Address - Fax:
Practice Address - Street 1:2101 BRIARWOOD CT
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2013
Practice Address - Country:US
Practice Address - Phone:410-310-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-311434174N00000X
WALL60023046235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN