Provider Demographics
NPI:1013998988
Name:WATTS, JULIE FOLEY (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:FOLEY
Last Name:WATTS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MARGARET
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8777 SAN JOSE BLVD STE 701
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4292
Mailing Address - Country:US
Mailing Address - Phone:904-733-8255
Mailing Address - Fax:904-733-5034
Practice Address - Street 1:8777 SAN JOSE BLVD STE 701
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4292
Practice Address - Country:US
Practice Address - Phone:904-733-8255
Practice Address - Fax:904-733-5034
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLN/A222Q00000X
235Z00000X
FLSA4027235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL883557800Medicaid
FL883557801Medicaid