Provider Demographics
NPI:1992747166
Name:CORDRY, JULIE MICHELLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MICHELLE
Last Name:CORDRY
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 1:1905 CHADWICK DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-3788
Mailing Address - Country:US
Mailing Address - Phone:770-844-1691
Mailing Address - Fax:770-844-1691
Practice Address - Street 1:1905 CHADWICK DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-3788
Practice Address - Country:US
Practice Address - Phone:770-844-1691
Practice Address - Fax:770-844-1691
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5213235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist