Provider Demographics
NPI:1023406436
Name:RICHARD, JULIA ANN (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN
Last Name:RICHARD
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:RICHARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 50631
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76206-0631
Mailing Address - Country:US
Mailing Address - Phone:270-403-7922
Mailing Address - Fax:
Practice Address - Street 1:1400 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3040
Practice Address - Country:US
Practice Address - Phone:817-205-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21809235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist