Provider Demographics
NPI:1831930874
Name:SCOPP, JULIA GRACE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:GRACE
Last Name:SCOPP
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 1:20315 SUTTER CREEK DR APT 209
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-3957
Mailing Address - Country:US
Mailing Address - Phone:262-366-7700
Mailing Address - Fax:
Practice Address - Street 1:19601 W BLUEMOUND RD STE 120
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-5974
Practice Address - Country:US
Practice Address - Phone:262-771-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6553154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist