Provider Demographics
NPI:1750510509
Name:HAYDT, JULIANNE
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:HAYDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 JEFFREY LN
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-1058
Mailing Address - Country:US
Mailing Address - Phone:484-347-1337
Mailing Address - Fax:
Practice Address - Street 1:141 JEFFREY LN
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18067-1058
Practice Address - Country:US
Practice Address - Phone:484-347-1337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist