Provider Demographics
NPI:1497048359
Name:DEWEY, JULIET (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JULIET
Middle Name:
Last Name:DEWEY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:JULIET
Other - Middle Name:
Other - Last Name:LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:6856 CASCADE DREAM CT
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-2346
Mailing Address - Country:US
Mailing Address - Phone:954-907-3040
Mailing Address - Fax:
Practice Address - Street 1:18531 NOLL RD NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7521
Practice Address - Country:US
Practice Address - Phone:360-396-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117696235Z00000X
NC13513235Z00000X
WALL60544605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003680000Medicaid
FLFE061ZMedicare Oscar/Certification