Basic Information
| Provider Information | |||||||||
| NPI: | 1164629481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUDKINS-GIFFIN | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | ELAINE | ||||||||
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| Credential: | M.S., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 181 OAK HILLS DR | ||||||||
| Address2: | |||||||||
| City: | TULLAHOMA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373887744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9314542434 | ||||||||
| FaxNumber: | 9314556308 | ||||||||
| Practice Location | |||||||||
| Address1: | 1805 NORTH JACKSON STREET SUITES 2 &3 | ||||||||
| Address2: | JACKSON MEDICAL PLAZA | ||||||||
| City: | TULLAHOMA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9313937964 | ||||||||
| FaxNumber: | 9314556308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 1946 | TN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.