Provider Demographics
NPI:1912133679
Name:DALEY, JULIE (MS ED, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:DALEY
Suffix:
Gender:F
Credentials:MS ED, CCC/SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED, CCC/SLP
Mailing Address - Street 1:50 RIPLEY PLACE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213
Mailing Address - Country:US
Mailing Address - Phone:716-926-1770
Mailing Address - Fax:
Practice Address - Street 1:6050 FAIRWAY CT
Practice Address - Street 2:
Practice Address - City:LAKE VIEW
Practice Address - State:NY
Practice Address - Zip Code:14085-9568
Practice Address - Country:US
Practice Address - Phone:716-926-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016158-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist