Provider Demographics
NPI:1255030821
Name:MCDERMOTT, JULIE SCHMIDT (CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:SCHMIDT
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 S 2500 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-3242
Mailing Address - Country:US
Mailing Address - Phone:801-712-4833
Mailing Address - Fax:
Practice Address - Street 1:1850 S 2500 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-3242
Practice Address - Country:US
Practice Address - Phone:801-481-4814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5370943-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT5370943-4102OtherUTAH DEPARTMENT OF PROFESSIONAL LICENSING