Provider Demographics
NPI:1689800195
Name:PRATT, JULIE Y (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:Y
Last Name:PRATT
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1001 LAURENCE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-2979
Mailing Address - Country:US
Mailing Address - Phone:517-750-4777
Mailing Address - Fax:517-782-4717
Practice Address - Street 1:1001 LAURENCE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2979
Practice Address - Country:US
Practice Address - Phone:517-750-4777
Practice Address - Fax:517-782-4717
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI09127493OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION