Provider Demographics
NPI:1740459379
Name:PATTERSON, JULIE MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:MARIE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1722 SOUTH CARSON AVE
Mailing Address - Street 2:#1904
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4697
Mailing Address - Country:US
Mailing Address - Phone:918-639-2529
Mailing Address - Fax:
Practice Address - Street 1:2208 W DETROIT ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-3630
Practice Address - Country:US
Practice Address - Phone:918-806-0106
Practice Address - Fax:918-806-0113
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK3081235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist