Individual
JULIE GENET BOHANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
3294 S 202ND EAST AVE, BROKEN ARROW, OK 74014
(918) 973-0275
Mailing address
3294 S 202ND EAST AVE, BROKEN ARROW, OK 74014-1940
(918) 973-0275
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3045
OK
Other
Enumeration date
12/01/2011
Last updated
10/29/2021
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