MEDICARE: JULIE ANN SORRICK M.A. 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
1	235Z00000X	Speech-Language Pathologist	SLP1101	AZ

General Provider Information

NPI Number	:	1255491072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANN SORRICK M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	1828 W NIGHTHAWK WAY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85045-1632
Country	:	US
Telephone Number	:	480-704-7417
Fax Number	:

Provider Business Practice Location Address
First Line	:	1828 W NIGHTHAWK WAY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85045-1632
Country	:	US
Telephone Number	:	480-704-7417
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/08/2007

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Directions to “ JULIE ANN SORRICK M.A. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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