Provider Demographics
NPI:1710111414
Name:FAMIGLIETTI, JULIE D (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:D
Last Name:FAMIGLIETTI
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 1:702 CUTTER CT
Mailing Address - Street 2:
Mailing Address - City:KURE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28449-4913
Mailing Address - Country:US
Mailing Address - Phone:910-409-6167
Mailing Address - Fax:
Practice Address - Street 1:702 CUTTER CT
Practice Address - Street 2:
Practice Address - City:KURE BEACH
Practice Address - State:NC
Practice Address - Zip Code:28449-4913
Practice Address - Country:US
Practice Address - Phone:910-409-6167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-08
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8331235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist