Provider Demographics
NPI:1154533792
Name:HIATT, JULIE MARIE (MA, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARIE
Last Name:HIATT
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BATTLEGROUND AVE
Mailing Address - Street 2:SUITE 204 B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-8042
Mailing Address - Country:US
Mailing Address - Phone:336-373-9600
Mailing Address - Fax:336-373-9676
Practice Address - Street 1:1400 BATTLEGROUND AVE
Practice Address - Street 2:SUITE 204 B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8042
Practice Address - Country:US
Practice Address - Phone:336-373-9600
Practice Address - Fax:336-373-9676
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6672231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist