Healthcare Provider Details
I. General information
NPI: 1831746304
Provider Name (Legal Business Name): JULIE FOSHEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/20/2019
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1006 S ARKANSAS AVE
RUSSELLVILLE AR
72801-6733
US
IV. Provider business mailing address
3325 PEBBLE BEACH RD APT 5
CONWAY AR
72034-8752
US
V. Phone/Fax
- Phone: 479-890-5733
- Fax:
- Phone: 870-582-2477
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: