Provider Demographics
NPI:1891815700
Name:TULLY, JOANNE B (MA,CCC,SLP A)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:B
Last Name:TULLY
Suffix:
Gender:F
Credentials:MA,CCC,SLP A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CORNERSTONE DRIVE
Mailing Address - Street 2:SUITE 703
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:267-689-1000
Mailing Address - Fax:267-689-1008
Practice Address - Street 1:3 CORNERSTONE DRIVE
Practice Address - Street 2:STE. 703
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:267-689-1000
Practice Address - Fax:267-689-1008
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000224L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist