Provider Demographics
NPI:1831334622
Name:AUTRY-JONES, JULIE (MA, FAAO)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:AUTRY-JONES
Suffix:
Gender:F
Credentials:MA, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3326
Mailing Address - Country:US
Mailing Address - Phone:330-296-0100
Mailing Address - Fax:330-296-0105
Practice Address - Street 1:950 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3326
Practice Address - Country:US
Practice Address - Phone:330-296-0100
Practice Address - Fax:330-296-0105
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00909231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
562297707OtherANTHEM