Provider Demographics
NPI:1720514755
Name:NAGEL, JULIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:NAGEL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:ELISE
Other - Last Name:NAGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JULIE NAGEL CCC-SLP
Mailing Address - Street 1:97 BENTHAVEN PL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6200
Mailing Address - Country:US
Mailing Address - Phone:972-400-3342
Mailing Address - Fax:
Practice Address - Street 1:97 BENTHAVEN PL
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6200
Practice Address - Country:US
Practice Address - Phone:972-400-3342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112328235Z00000X
14264095235Z00000X
COSLP.0004162235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist