Provider Demographics
NPI:1336443381
Name:CAGLE, JULIA LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:LYNN
Last Name:CAGLE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MERRIDUN LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-1933
Mailing Address - Country:US
Mailing Address - Phone:803-727-4436
Mailing Address - Fax:
Practice Address - Street 1:3227 HARRISON RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2657
Practice Address - Country:US
Practice Address - Phone:803-622-4482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4132235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist