Provider Demographics
NPI:1649330267
Name:GOULET, JULIE (SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:GOULET
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 DANIEL WEBSTER HWY
Mailing Address - Street 2:UNIT 1
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-4169
Mailing Address - Country:US
Mailing Address - Phone:603-424-1950
Mailing Address - Fax:603-424-4749
Practice Address - Street 1:370 DANIEL WEBSTER HWY
Practice Address - Street 2:UNIT 1
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-4152
Practice Address - Country:US
Practice Address - Phone:603-424-1950
Practice Address - Fax:603-424-4749
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0270OtherLICENSE #