Provider Demographics
NPI:1891862041
Name:WRIGHT, JULIANNE LOUISE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JULIANNE
Middle Name:LOUISE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 W MAIN ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-1292
Mailing Address - Country:US
Mailing Address - Phone:334-790-8607
Mailing Address - Fax:
Practice Address - Street 1:2323 W MAIN ST
Practice Address - Street 2:SUITE 107
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1292
Practice Address - Country:US
Practice Address - Phone:334-790-8607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2198174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA7199OtherSTATE OF FLORIDA DEPT. OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
AL2198OtherLICENSE
GASLP 005756OtherSTATE OF GEORGIA BOARD FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY