Provider Demographics
NPI:1740309376
Name:STEWART, JULIE CHRISTINE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:CHRISTINE
Last Name:STEWART
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 BUCCANEER TER
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5409
Mailing Address - Country:US
Mailing Address - Phone:941-925-8633
Mailing Address - Fax:
Practice Address - Street 1:1805 BUCCANEER TER
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5409
Practice Address - Country:US
Practice Address - Phone:941-925-8633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist