Provider Demographics
NPI:1770667065
Name:KORTE, JULIE NELSON (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:NELSON
Last Name:KORTE
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 1:10812 THISTLE RDG
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2252
Mailing Address - Country:US
Mailing Address - Phone:317-985-6458
Mailing Address - Fax:317-585-9057
Practice Address - Street 1:10812 THISTLE RDG
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2252
Practice Address - Country:US
Practice Address - Phone:317-985-6458
Practice Address - Fax:317-585-9057
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003136A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist