Provider Demographics
NPI:1841397957
Name:WEBSTER, JULIA ANN (MST SLP-CCC)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ANN
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MST SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W7133 770TH AVE
Mailing Address - Street 2:
Mailing Address - City:BELDENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54003-5423
Mailing Address - Country:US
Mailing Address - Phone:715-425-6410
Mailing Address - Fax:
Practice Address - Street 1:2705 ENLOE ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8173
Practice Address - Country:US
Practice Address - Phone:715-386-2128
Practice Address - Fax:715-386-6119
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1653235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42765400Medicaid
15665OtherHEALTH PARTNERS
MN98G39MUOtherMN BCBS
641671046996OtherPREFERRED ONE
4600265OtherMEDICA
7066120OtherAETNA