Provider Demographics
NPI:1184770422
Name:MARGIOTTA, JULIE KRISTINA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:KRISTINA
Last Name:MARGIOTTA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:KRISTINA
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1177 N. WARSON RD
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132
Mailing Address - Country:US
Mailing Address - Phone:314-569-2211
Mailing Address - Fax:314-569-0778
Practice Address - Street 1:1177 N. WARSON RD
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132
Practice Address - Country:US
Practice Address - Phone:314-569-2211
Practice Address - Fax:314-569-0778
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005028678235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist