Provider Demographics
NPI:1861723488
Name:MAULE, BJ (MS, CCC-SP)
Entity type:Individual
Prefix:
First Name:BJ
Middle Name:
Last Name:MAULE
Suffix:
Gender:F
Credentials:MS, CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6912 220TH ST SW
Mailing Address - Street 2:SUITE 213
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2169
Mailing Address - Country:US
Mailing Address - Phone:425-672-2716
Mailing Address - Fax:425-672-2720
Practice Address - Street 1:6912 220TH ST SW
Practice Address - Street 2:SUITE 213
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2169
Practice Address - Country:US
Practice Address - Phone:425-672-2716
Practice Address - Fax:425-672-2720
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00001944235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist