Basic Information
| Provider Information | |||||||||
| NPI: | 1356479976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WITTEN | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.ED., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 591 LINWOOD AVE NE | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303064426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048790128 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1441 CLIFTON ROAD, N.E. | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047127249 | ||||||||
| FaxNumber: | 4047125974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SLP006079 | GA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.