Provider Demographics
NPI:1770788259
Name:BEHR, JULIE THERESE (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:THERESE
Last Name:BEHR
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 MICHIGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-4905
Mailing Address - Country:US
Mailing Address - Phone:313-610-6422
Mailing Address - Fax:
Practice Address - Street 1:325 S PECK AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6946
Practice Address - Country:US
Practice Address - Phone:310-318-7345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15360235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist