Provider Demographics
NPI:1629246301
Name:HEATH, JULIE LENAY
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LENAY
Last Name:HEATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8204 LOCH RAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-8203
Mailing Address - Country:US
Mailing Address - Phone:410-823-2710
Mailing Address - Fax:
Practice Address - Street 1:1415 ROUTE 70 E
Practice Address - Street 2:SUITE 103
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2210
Practice Address - Country:US
Practice Address - Phone:800-670-3893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05021235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist