Provider Demographics
NPI:1821086943
Name:RADEMACHER, JULIA ELLEN (MA, MM, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ELLEN
Last Name:RADEMACHER
Suffix:
Gender:F
Credentials:MA, MM, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S JORDAN AVE
Mailing Address - Street 2:DEPARTMENT OF SPEECH AND HEARING SCIENCES
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47405-7002
Mailing Address - Country:US
Mailing Address - Phone:812-856-4727
Mailing Address - Fax:812-855-5561
Practice Address - Street 1:200 S JORDAN AVE
Practice Address - Street 2:DEPARTMENT OF SPEECH AND HEARING SCIENCES
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47405-7002
Practice Address - Country:US
Practice Address - Phone:812-856-4727
Practice Address - Fax:812-855-5561
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003308A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN11512054OtherCAQH PROVIDER NUMBER
IN11512054OtherCAQH PROVIDER NUMBER