Provider Demographics
NPI:1831243674
Name:SOSEBEE, JULIE ANN (SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:SOSEBEE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:PIETRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:7937 RHEA COUNTY HWY
Practice Address - Street 2:SUITE 104
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-5990
Practice Address - Country:US
Practice Address - Phone:423-270-0907
Practice Address - Fax:423-570-0936
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP0861235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446652Medicaid
TN3156797OtherBCBS OF TN
TN5441433Medicaid
TN5441433Medicaid