Provider Demographics
NPI:1720647282
Name:HIRN, JULIANA LYNN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:LYNN
Last Name:HIRN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3349 STONEBRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-9232
Mailing Address - Country:US
Mailing Address - Phone:137-272-0508
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:3349 STONEBRIDGE TRL
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-9232
Practice Address - Country:US
Practice Address - Phone:813-727-2050
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.13891235Z00000X
FLSZ9054235Z00000X
GASLP011251235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist