Provider Demographics
NPI:1639302433
Name:DROKER, JULIE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:DROKER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 E OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-6018
Mailing Address - Country:US
Mailing Address - Phone:480-484-3457
Mailing Address - Fax:
Practice Address - Street 1:4610 E OSBORN RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-6018
Practice Address - Country:US
Practice Address - Phone:480-484-3457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4196882235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4196882OtherARIZONA DEPARTMENT OF ED CERTIFICATE SPEECH-LANGUAGE PATHOLOGIST