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NPI Code Detail

MEDICARE: MRS. JULIE FOLEY WATTS MS CCC-SLP

MEDICARE: MRS. JULIE FOLEY WATTS MS CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental TherapistN/AFL
2235Z00000XSpeech-Language Pathologist
3235Z00000XSpeech-Language PathologistSA4027FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013998988
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIE FOLEY WATTS MS CCC-SLP
Provider Business Mailing Address
First Line : 8777 SAN JOSE BLVD STE 701
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-4292
Country : US
Telephone Number : 904-733-8255
Fax Number : 904-733-5034
Provider Business Practice Location Address
First Line : 8777 SAN JOSE BLVD STE 701
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-4292
Country : US
Telephone Number : 904-733-8255
Fax Number : 904-733-5034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 09/12/2021

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