Basic Information
| Provider Information | |||||||||
| NPI: | 1346335775 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRASK | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | RENEE | ||||||||
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| Credential: | CCC/SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3932 CREEK HOLLOW WAY | ||||||||
| Address2: | |||||||||
| City: | THE COLONY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726241614 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1201 E. 15TH STREET | ||||||||
| Address2: | SUITE 304 | ||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724240148 | ||||||||
| FaxNumber: | 9724225275 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 18161 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.