Provider Demographics
NPI:1629256466
Name:BINGHAM, JULIE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:MCINTYRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7015 CARNATION ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5294
Mailing Address - Country:US
Mailing Address - Phone:804-272-1927
Mailing Address - Fax:804-272-1928
Practice Address - Street 1:7015 CARNATION ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-5294
Practice Address - Country:US
Practice Address - Phone:804-272-1927
Practice Address - Fax:804-272-1928
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003946235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist