Provider Demographics
NPI:1952700494
Name:CLOUSE, JULIA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:
Last Name:CLOUSE
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 1:97 ASTRO WAY
Mailing Address - Street 2:
Mailing Address - City:SABINA
Mailing Address - State:OH
Mailing Address - Zip Code:45169-9521
Mailing Address - Country:US
Mailing Address - Phone:937-584-2461
Mailing Address - Fax:
Practice Address - Street 1:97 ASTRO WAY
Practice Address - Street 2:
Practice Address - City:SABINA
Practice Address - State:OH
Practice Address - Zip Code:45169-9521
Practice Address - Country:US
Practice Address - Phone:937-584-2461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3063631235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist