Provider Demographics
NPI:1861645939
Name:PARKER, JULIA C (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:C
Last Name:PARKER
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 DARTMOORE LN
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3342
Mailing Address - Country:US
Mailing Address - Phone:678-513-0477
Mailing Address - Fax:
Practice Address - Street 1:4705 DARTMOORE LN
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-3342
Practice Address - Country:US
Practice Address - Phone:678-513-0477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-02
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4120235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist