Provider Demographics
NPI:1710571948
Name:WOLFROM, JULIA B (MSA, MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:B
Last Name:WOLFROM
Suffix:
Gender:F
Credentials:MSA, MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 KNOTTY OAK DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2109
Mailing Address - Country:US
Mailing Address - Phone:215-284-6474
Mailing Address - Fax:
Practice Address - Street 1:16 SCRAPETOWN RD
Practice Address - Street 2:
Practice Address - City:PEMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08068-1952
Practice Address - Country:US
Practice Address - Phone:609-893-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-28
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00381700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist