Provider Demographics
NPI:1952298762
Name:GRAHAM, JULIA MARIE (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3348 E 9TH RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:IL
Mailing Address - Zip Code:61373-9678
Mailing Address - Country:US
Mailing Address - Phone:815-830-9595
Mailing Address - Fax:
Practice Address - Street 1:170 E WALNUT ST STE B
Practice Address - Street 2:
Practice Address - City:OGLESBY
Practice Address - State:IL
Practice Address - Zip Code:61348-1202
Practice Address - Country:US
Practice Address - Phone:815-993-9260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2706010235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist