Provider Demographics
NPI:1780004648
Name:MOHAN, JULIE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:MOHAN
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 1:650 FRIAR DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-3467
Mailing Address - Country:US
Mailing Address - Phone:267-566-2472
Mailing Address - Fax:
Practice Address - Street 1:650 FRIAR DR
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-3467
Practice Address - Country:US
Practice Address - Phone:267-566-2472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011624235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist