Provider Demographics
NPI:1255511762
Name:KOWALSKI, JULIE ANN (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:KOWALSKI
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 1:6109 WOODFORD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:NY
Mailing Address - Zip Code:14085-9457
Mailing Address - Country:US
Mailing Address - Phone:716-335-8888
Mailing Address - Fax:
Practice Address - Street 1:4242 RIDGE LEA RD
Practice Address - Street 2:SUITE 2
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1051
Practice Address - Country:US
Practice Address - Phone:716-819-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011336-1235Z00000X
NY011336235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist