Healthcare Provider Details

I. General information

NPI: 1629416680
Provider Name (Legal Business Name): JULIE MARIE TOBIN M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE MARIE PASCHKE M. S. CCC-SLP

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10243 W NATIONAL AVE
WEST ALLIS WI
53227-2028
US

IV. Provider business mailing address

10243 W NATIONAL AVE
WEST ALLIS WI
53227-2028
US

V. Phone/Fax

Practice location:
  • Phone: 414-604-2200
  • Fax:
Mailing address:
  • Phone: 414-604-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3968-154
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number3968-154
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number10491
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: