Healthcare Provider Details

I. General information

NPI: 1821797671
Provider Name (Legal Business Name): JULENE CLARICE WOOLSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2077 W ROYAL HUNTE DR
CEDAR CITY UT
84720-1883
US

IV. Provider business mailing address

2077 W ROYAL HUNTE DR
CEDAR CITY UT
84720-1883
US

V. Phone/Fax

Practice location:
  • Phone: 435-586-2804
  • Fax:
Mailing address:
  • Phone: 435-586-2804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: