Healthcare Provider Details

I. General information

NPI: 1568594265
Provider Name (Legal Business Name): JULIE KOTLER M.S. CF- SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15245 SHADY GROVE RD SUITE 110
ROCKVILLE MD
20850-3222
US

IV. Provider business mailing address

9907 GABLE RIDGE TER APT H
ROCKVILLE MD
20850-4635
US

V. Phone/Fax

Practice location:
  • Phone: 301-208-3210
  • Fax: 301-208-6686
Mailing address:
  • Phone: 301-208-3210
  • Fax: 301-208-6686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: