Provider Demographics
NPI:1023138005
Name:BULLOUGH, JONI SKINNER (AUD)
Entity type:Individual
Prefix:DR
First Name:JONI
Middle Name:SKINNER
Last Name:BULLOUGH
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 1:181 NORTHAMPTON ST
Mailing Address - Street 2:STE. F
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1181
Mailing Address - Country:US
Mailing Address - Phone:413-221-7423
Mailing Address - Fax:
Practice Address - Street 1:45 ROUND HILL RD
Practice Address - Street 2:CLARKE SCHOOL CENTER FOR AUDIOLOGICAL SERVICES
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2123
Practice Address - Country:US
Practice Address - Phone:413-582-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA782231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist