Provider Demographics
NPI:1760639371
Name:SPECK, JULIE FARNSWORTH (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:FARNSWORTH
Last Name:SPECK
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 1:1915 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8768
Mailing Address - Country:US
Mailing Address - Phone:515-232-7220
Mailing Address - Fax:
Practice Address - Street 1:1915 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8768
Practice Address - Country:US
Practice Address - Phone:515-232-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01668235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist