Provider Demographics
NPI:1548504301
Name:BRICK, JULIE ANN (MS,CCC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:BRICK
Suffix:
Gender:F
Credentials:MS,CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 E PLATEAU RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3309
Mailing Address - Country:US
Mailing Address - Phone:509-703-7636
Mailing Address - Fax:
Practice Address - Street 1:711 E PLATEAU RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3309
Practice Address - Country:US
Practice Address - Phone:509-703-7636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-18
Last Update Date:2012-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00002935235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist