Provider Demographics
NPI:1134519036
Name:GASSERT, JULIETTE (AUD)
Entity type:Individual
Prefix:DR
First Name:JULIETTE
Middle Name:
Last Name:GASSERT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 BAYFRONT DR UNIT 511
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-1857
Mailing Address - Country:US
Mailing Address - Phone:301-520-6084
Mailing Address - Fax:
Practice Address - Street 1:900 JOHNNIE DODDS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6177
Practice Address - Country:US
Practice Address - Phone:843-849-8604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3037231H00000X
SC4065231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist