Provider Demographics
NPI:1003217464
Name:HANSEN, JULIANNE (TSSLD)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2746
Mailing Address - Country:US
Mailing Address - Phone:585-473-2858
Mailing Address - Fax:585-461-3771
Practice Address - Street 1:941 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2746
Practice Address - Country:US
Practice Address - Phone:585-473-2858
Practice Address - Fax:585-461-3771
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist