Provider Demographics
NPI:1942750716
Name:ADAMS, JULIE (MS-CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ADAMS
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 1:117 S. DOUGLAS BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130
Mailing Address - Country:US
Mailing Address - Phone:405-259-9478
Mailing Address - Fax:405-259-8332
Practice Address - Street 1:117 S. DOUGLAS BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130
Practice Address - Country:US
Practice Address - Phone:405-259-9478
Practice Address - Fax:405-259-8332
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3821235Z00000X
VA2202008047235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1174898506Medicaid