Provider Demographics
NPI:1760188338
Name:AZZIZZO, JULIANNA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:
Last Name:AZZIZZO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 RIVER RD APT D3
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-2028
Mailing Address - Country:US
Mailing Address - Phone:973-800-5145
Mailing Address - Fax:
Practice Address - Street 1:70 RIVER RD APT D3
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07014-2028
Practice Address - Country:US
Practice Address - Phone:973-800-5145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01064800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14337465OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION (ASHA)
NJ41YS01064800OtherNEW JERSEY DIVISION OF CONSUMER AFFAIRS