Provider Demographics
NPI:1952617516
Name:METZGER, JULIA LESLIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:LESLIE
Last Name:METZGER
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 1:471 HORSESHOE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SWAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12783-5233
Mailing Address - Country:US
Mailing Address - Phone:516-426-2579
Mailing Address - Fax:845-791-1738
Practice Address - Street 1:68 HARRIS BUSHVILLE RD
Practice Address - Street 2:
Practice Address - City:HARRIS
Practice Address - State:NY
Practice Address - Zip Code:12742
Practice Address - Country:US
Practice Address - Phone:845-794-3300
Practice Address - Fax:845-791-1738
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist