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General NPI Number Information
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NPI Number | 1205287034
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Entity Type | Individual
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Provider Name | JULIA GREMILLION BRYN M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/22/2016
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 10904 DAUPHINE ST
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City | SHREVEPORT
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State | LA
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Zip | 71106-8531
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Country | US
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Telephone | 318-359-2356
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Fax |
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Provider Business Mailing Address
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Address Line | 67 S HIGLEY RD STE 103-477
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City | GILBERT
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State | AZ
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Zip | 85296-1166
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Country | US
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Telephone | 318-359-2356
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7637
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 6501
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License Number State | TX
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