Provider Demographics
NPI:1811236516
Name:CONLEY-JOHNSON, JULIE ANNE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:CONLEY-JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 JESSICA DR
Mailing Address - Street 2:
Mailing Address - City:PENN LAIRD
Mailing Address - State:VA
Mailing Address - Zip Code:22846-2032
Mailing Address - Country:US
Mailing Address - Phone:540-435-1955
Mailing Address - Fax:
Practice Address - Street 1:149 JESSICA DR
Practice Address - Street 2:
Practice Address - City:PENN LAIRD
Practice Address - State:VA
Practice Address - Zip Code:22846-2032
Practice Address - Country:US
Practice Address - Phone:540-435-1955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005299235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist