MEDICARE: MRS. JULIE POWELL JENKINS M.S., 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	283	NM

General Provider Information

NPI Number	:	1740296250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE POWELL JENKINS M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	7200 HEARTH DR NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2922
Country	:	US
Telephone Number	:	505-463-8765
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 PARK AVE SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-2840
Country	:	US
Telephone Number	:	505-242-1047
Fax Number	:

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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Directions to “ MRS. JULIE POWELL JENKINS M.S., CCC-SLP” Practice Location

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