Provider Demographics
NPI:1619427473
Name:LEVITT, JUNKO
Entity Type:Individual
Prefix:DR
First Name:JUNKO
Middle Name:
Last Name:LEVITT
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:JUNE
Other - Middle Name:
Other - Last Name:LEVITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LDT, CCC-SLP
Mailing Address - Street 1:6038 SHETLAND DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1850
Mailing Address - Country:US
Mailing Address - Phone:214-674-1585
Mailing Address - Fax:
Practice Address - Street 1:6038 SHETLAND DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1850
Practice Address - Country:US
Practice Address - Phone:214-674-1585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist