Provider Demographics
NPI:1669292678
Name:POCH, JULIA (CF, SLP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:POCH
Suffix:
Gender:F
Credentials:CF, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96232 RIDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-8160
Mailing Address - Country:US
Mailing Address - Phone:678-761-2863
Mailing Address - Fax:855-565-1769
Practice Address - Street 1:22391 FLORA PARKE XING UNIT A
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-8005
Practice Address - Country:US
Practice Address - Phone:904-321-9054
Practice Address - Fax:855-565-1769
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ12368235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist