Provider Demographics
NPI:1477726008
Name:KING, JULIA M (PHD)
Entity Type:Individual
Prefix:PROF
First Name:JULIA
Middle Name:M
Last Name:KING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 4TH AVE
Mailing Address - Street 2:UNIVERSITY OF WISCONSIN STEVENS POINT
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1909
Mailing Address - Country:US
Mailing Address - Phone:715-346-4657
Mailing Address - Fax:715-346-2157
Practice Address - Street 1:1901 4TH AVE
Practice Address - Street 2:UNIVERSITY OF WISCONSIN STEVENS POINT
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1909
Practice Address - Country:US
Practice Address - Phone:715-346-4657
Practice Address - Fax:715-346-2157
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1798-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41135400Medicaid