Provider Demographics
NPI:1437351426
Name:DAVIDSON, JULIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 PAMELAS LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2362
Mailing Address - Country:US
Mailing Address - Phone:717-795-8235
Mailing Address - Fax:
Practice Address - Street 1:810 PAMELAS LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2362
Practice Address - Country:US
Practice Address - Phone:717-795-8235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007029235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist