Provider Demographics
NPI:1962525725
Name:JULIE L. WATSON
Entity type:Organization
Organization Name:JULIE L. WATSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA-SLP
Authorized Official - Phone:812-453-2452
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22000028A235Z00000X
IN282N00000X282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN=========OtherSPEECH PATHOLOGY