Provider Demographics
NPI:1215784780
Name:PEPITONE, JULIA CHRISTINE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:CHRISTINE
Last Name:PEPITONE
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 1:28 BIRCHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-2243
Mailing Address - Country:US
Mailing Address - Phone:860-878-4105
Mailing Address - Fax:
Practice Address - Street 1:28 BIRCHVIEW DR
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-2243
Practice Address - Country:US
Practice Address - Phone:860-878-4105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT18.007871235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist