Provider Demographics
NPI:1881962397
Name:WOODBURY, JULIANN CLARK (MS, CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:JULIANN
Middle Name:CLARK
Last Name:WOODBURY
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 FOLSOM DR
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-2050
Mailing Address - Country:US
Mailing Address - Phone:603-659-2105
Mailing Address - Fax:603-778-0388
Practice Address - Street 1:11 SANDY POINT RD
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2121
Practice Address - Country:US
Practice Address - Phone:603-778-8193
Practice Address - Fax:603-778-0388
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0566235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist