Provider Demographics
NPI:1407303654
Name:SIPIOR, JUDY MARIE (MS CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:MARIE
Last Name:SIPIOR
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HAREWOOD RUN
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-5009
Mailing Address - Country:US
Mailing Address - Phone:716-343-4013
Mailing Address - Fax:
Practice Address - Street 1:675 POTTERS RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2652
Practice Address - Country:US
Practice Address - Phone:716-677-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist