Provider Demographics
NPI:1669838488
Name:BORDONARO, JULIE (MCD CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:BORDONARO
Suffix:
Gender:F
Credentials:MCD CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 ROSA AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2849
Mailing Address - Country:US
Mailing Address - Phone:504-832-5111
Mailing Address - Fax:
Practice Address - Street 1:664 ROSA AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2849
Practice Address - Country:US
Practice Address - Phone:504-832-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3344235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist