Provider Demographics
NPI:1831359652
Name:WATSON, JULIE LYNN
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:WATSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 BARKER RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-2305
Mailing Address - Country:US
Mailing Address - Phone:812-453-2452
Mailing Address - Fax:270-831-1875
Practice Address - Street 1:211 BARKER RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2305
Practice Address - Country:US
Practice Address - Phone:812-453-2452
Practice Address - Fax:270-831-1875
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22000028A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist