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NPI Code Detail

MEDICARE: JULIA TREJO M.ED CCC-SLP

MEDICARE: JULIA TREJO M.ED 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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1033624911
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA TREJO M.ED CCC-SLP
Provider Business Mailing Address
First Line : 3166 READSBOROUGH CT
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-2618
Country : US
Telephone Number : 571-335-3513
Fax Number :
Provider Business Practice Location Address
First Line : 5695 KING CENTRE DR STE 100
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22315-5745
Country : US
Telephone Number : 571-303-1298
Fax Number : 540-720-5660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2017
Last Update Date : 03/16/2023

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Directions to “ JULIA TREJO M.ED CCC-SLP” Practice Location

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