Provider Demographics
NPI:1639186091
Name:HANSEN-JONES, JULIE ANN (MA,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:HANSEN-JONES
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 1:6822 22ND AVE N # 233
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-3918
Mailing Address - Country:US
Mailing Address - Phone:727-743-3453
Mailing Address - Fax:813-641-7899
Practice Address - Street 1:6822 22ND AVE N # 233
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-3918
Practice Address - Country:US
Practice Address - Phone:727-743-3453
Practice Address - Fax:813-641-7899
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5680235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist