Provider Demographics
NPI:1215937206
Name:BULL, JEANNE GINOCCHIO (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:GINOCCHIO
Last Name:BULL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:JEANNE
Other - Middle Name:ELIZABETH
Other - Last Name:GINOCCHIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 KIRKBY RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-3244
Mailing Address - Country:US
Mailing Address - Phone:912-856-1127
Mailing Address - Fax:
Practice Address - Street 1:6 KIRKBY RD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-3244
Practice Address - Country:US
Practice Address - Phone:912-856-1127
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005471235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist