Provider Demographics
NPI:1699803098
Name:CHILDS, JULIA CAROLYN (MS-CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:CAROLYN
Last Name:CHILDS
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 1:113 CHERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-2601
Mailing Address - Country:US
Mailing Address - Phone:412-213-0092
Mailing Address - Fax:
Practice Address - Street 1:3390 SAXONBURG BLVD # 250
Practice Address - Street 2:
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-3160
Practice Address - Country:US
Practice Address - Phone:412-767-5967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL 007970235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101117584Medicaid