Provider Demographics
NPI:1699090803
Name:MACANN, JULIE ANN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:MACANN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:AZZARELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:384 EAST AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1909
Mailing Address - Country:US
Mailing Address - Phone:585-720-9608
Mailing Address - Fax:
Practice Address - Street 1:384 EAST AVE STE B
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1909
Practice Address - Country:US
Practice Address - Phone:585-720-9608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009754235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist