Provider Demographics
NPI:1417380429
Name:BOIANO, JULIE ANNE (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:BOIANO
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 OLD CHAIN BRIDGE RD STE 185
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3945
Mailing Address - Country:US
Mailing Address - Phone:703-942-8110
Mailing Address - Fax:703-942-8042
Practice Address - Street 1:133 ROLLINS AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4040
Practice Address - Country:US
Practice Address - Phone:301-468-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01370231H00000X, 237600000X
VA2201001533231H00000X
VA2101002013237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA521669YGFFOtherMEDICARE