Provider Demographics
NPI:1700214889
Name:WELLS, JULIA ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:WELLS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10721 CHAPMAN HWY
Mailing Address - Street 2:SUITE 22
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-4765
Mailing Address - Country:US
Mailing Address - Phone:865-579-2293
Mailing Address - Fax:865-579-2295
Practice Address - Street 1:10721 CHAPMAN HWY
Practice Address - Street 2:SUITE 22
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-4765
Practice Address - Country:US
Practice Address - Phone:865-579-2293
Practice Address - Fax:865-579-2295
Is Sole Proprietor?:No
Enumeration Date:2013-10-28
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000951235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist