MEDICARE: JULIE CODY

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	1783	NC

General Provider Information

NPI Number	:	1508125071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE CODY

Provider Business Mailing Address
First Line	:	1404 ELBERON PLACE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 ELBERON PL
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-4010
Country	:	US
Telephone Number	:	919-876-3699
Fax Number	:

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

Provider Enumeration Date	:	05/03/2012
Last Update Date	:	05/03/2012

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Directions to “ JULIE CODY ” Practice Location

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