Provider Demographics
NPI:1285065565
Name:WALBERG, JULIA C (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:C
Last Name:WALBERG
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 1:489 MAIN STREET POMEORY HL
Mailing Address - Street 2:UNIVERSITY OF VERMONT
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05405-0130
Mailing Address - Country:US
Mailing Address - Phone:802-656-3861
Mailing Address - Fax:802-656-2528
Practice Address - Street 1:489 MAIN ST
Practice Address - Street 2:POMEROY HALL
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05405-0130
Practice Address - Country:US
Practice Address - Phone:802-656-3861
Practice Address - Fax:802-656-2528
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2014-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ASHA235Z00000X
VT8051732235Z00000X
12017687235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist