Provider Demographics
NPI:1609148717
Name:CLAXTON, JULIANE S (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIANE
Middle Name:S
Last Name:CLAXTON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MISS
Other - First Name:JULIANE
Other - Middle Name:
Other - Last Name:SOBON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:319 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-2240
Mailing Address - Country:US
Mailing Address - Phone:912-232-8007
Mailing Address - Fax:
Practice Address - Street 1:319 E 51ST ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-2240
Practice Address - Country:US
Practice Address - Phone:912-232-8007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-04
Last Update Date:2012-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist