MEDICARE: JULIA HELENE SLOBODA CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	032748	NY

General Provider Information

NPI Number	:	1720794464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA HELENE SLOBODA CCC-SLP

Provider Business Mailing Address
First Line	:	60 GEORGE ST APT 1
Second Line	:
City	:	TROY
State	:	NY
Zip	:	12183-1114
Country	:	US
Telephone Number	:	360-325-1781
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 GEORGE ST APT 1
Second Line	:
City	:	TROY
State	:	NY
Zip	:	12183-1114
Country	:	US
Telephone Number	:	360-325-1781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2023
Last Update Date	:	01/26/2023

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Directions to “ JULIA HELENE SLOBODA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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