Provider Demographics
NPI:1447396510
Name:WILLIAMS, JULIE LYN (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
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Mailing Address - Street 1:4751 MILESTRIP RD
Mailing Address - Street 2:
Mailing Address - City:BLASDELL
Mailing Address - State:NY
Mailing Address - Zip Code:14219-3001
Mailing Address - Country:US
Mailing Address - Phone:716-821-0663
Mailing Address - Fax:
Practice Address - Street 1:280 CENTRAL AVENUE W123 THOMPSON HALL
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063-1136
Practice Address - Country:US
Practice Address - Phone:716-673-3203
Practice Address - Fax:716-673-3225
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY006784-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist