=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376414102
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE ANN HARTLEY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2025
-----------------------------------------------------
Last Update Date | 10/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 218 N MAIN ST
-----------------------------------------------------
City | FREELAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48623-9001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-860-0846
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2205 TRAUTNER DR
-----------------------------------------------------
City | SAGINAW
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48604-8201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-860-1425
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 7101001839
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------