Provider Demographics
NPI:1417222845
Name:ROBERTS, JULIE P (MA,CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:P
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 UNIVERSITY HALL DRIVE
Mailing Address - Street 2:ROOM 120
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28608-2041
Mailing Address - Country:US
Mailing Address - Phone:828-262-2185
Mailing Address - Fax:828-262-6766
Practice Address - Street 1:400 UNIVERSITY HALL DRIVE
Practice Address - Street 2:ROOM 120
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28608-2041
Practice Address - Country:US
Practice Address - Phone:828-262-2185
Practice Address - Fax:828-262-6766
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6490235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist