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NPI Code Detail

MEDICARE: JULIE RENEE ROARK SLP

MEDICARE:   JULIE RENEE ROARK  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 Pathologist1331AL

General Provider Information

NPI Number : 1629138128
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE RENEE ROARK SLP
Provider Business Mailing Address
First Line : 5732 12TH AVE S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35222-4112
Country : US
Telephone Number : 205-999-2376
Fax Number :
Provider Business Practice Location Address
First Line : 2970 LORNA RD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35216-4506
Country : US
Telephone Number : 205-979-2619
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 07/08/2007

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Directions to “ JULIE RENEE ROARK SLP” Practice Location

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