Provider Demographics
NPI:1861684326
Name:IZYKOWSKI, JULIE MEGAN (MSP CCC SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MEGAN
Last Name:IZYKOWSKI
Suffix:
Gender:F
Credentials:MSP CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11026 ASBURY CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-4625
Mailing Address - Country:US
Mailing Address - Phone:704-575-4222
Mailing Address - Fax:704-875-7112
Practice Address - Street 1:11026 ASBURY CHAPEL RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4625
Practice Address - Country:US
Practice Address - Phone:704-575-4222
Practice Address - Fax:704-875-7112
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC235Z00000X
NC8168235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist