Provider Demographics
NPI:1962078485
Name:VISAGGIO, JULIA (AUD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:VISAGGIO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CROSSROADS DR STE 400
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5490
Mailing Address - Country:US
Mailing Address - Phone:410-356-2626
Mailing Address - Fax:
Practice Address - Street 1:23 CROSSROADS DR STE 400
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5490
Practice Address - Country:US
Practice Address - Phone:410-356-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01554231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist