Provider Demographics
NPI:1619275997
Name:BAKER, JULIE MARIE (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:895 ISLAND PARK DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8314
Mailing Address - Country:US
Mailing Address - Phone:843-603-4567
Mailing Address - Fax:843-405-1321
Practice Address - Street 1:895 ISLAND PARK DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29492-8314
Practice Address - Country:US
Practice Address - Phone:843-603-4567
Practice Address - Fax:843-405-1321
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4050235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist