Provider Demographics
NPI:1750596011
Name:RICE, JULIE LYNNE (MSCCCSLP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LYNNE
Last Name:RICE
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4369 S TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-5225
Mailing Address - Country:US
Mailing Address - Phone:414-744-1258
Mailing Address - Fax:
Practice Address - Street 1:1700 C A BECKER DR
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-4714
Practice Address - Country:US
Practice Address - Phone:262-637-9751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1747-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist