Provider Demographics
NPI:1750759981
Name:POOLE, JULIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:POOLE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4610
Mailing Address - Country:US
Mailing Address - Phone:970-275-9206
Mailing Address - Fax:
Practice Address - Street 1:1500 W LITTLETON BLVD
Practice Address - Street 2:SUITE 127
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2156
Practice Address - Country:US
Practice Address - Phone:720-684-5877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0002213235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist