Provider Demographics
NPI:1285758854
Name:KOUZEL, JULIE (SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KOUZEL
Suffix:
Gender:
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FOREST WALK WAY
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-6993
Mailing Address - Country:US
Mailing Address - Phone:919-606-9776
Mailing Address - Fax:
Practice Address - Street 1:18047 W CATAWBA AVE STE 203
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5688
Practice Address - Country:US
Practice Address - Phone:704-896-8688
Practice Address - Fax:704-896-7975
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4186235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412144Medicaid