Provider Demographics
NPI:1174035869
Name:MELLO, JULIE (MS, CCC-SLP, ATP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MELLO
Suffix:
Gender:F
Credentials:MS, CCC-SLP, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MA
Mailing Address - Zip Code:01469-1332
Mailing Address - Country:US
Mailing Address - Phone:781-527-4753
Mailing Address - Fax:781-527-4759
Practice Address - Street 1:24 HICKORY DR
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:MA
Practice Address - Zip Code:01469-1332
Practice Address - Country:US
Practice Address - Phone:781-527-4753
Practice Address - Fax:781-527-4759
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225CA2400X
MA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner