Provider Demographics
NPI:1376709139
Name:BEENAU, JULIA M (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:M
Last Name:BEENAU
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1402
Mailing Address - Country:US
Mailing Address - Phone:716-656-2225
Mailing Address - Fax:
Practice Address - Street 1:29 FOREST DR
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1402
Practice Address - Country:US
Practice Address - Phone:716-656-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011788-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist