Provider Demographics
NPI:1841525011
Name:MARSHALL, JULIE L (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:L
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:SABLE
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT 128
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0128
Mailing Address - Country:US
Mailing Address - Phone:901-821-0338
Mailing Address - Fax:901-821-0384
Practice Address - Street 1:807 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-5042
Practice Address - Country:US
Practice Address - Phone:901-678-5800
Practice Address - Fax:901-525-1282
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000722235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist