Provider Demographics
NPI:1295139442
Name:DREYER, JULIANNE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:DREYER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HOLBROOK ST
Mailing Address - Street 2:APT. 2F
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-1205
Mailing Address - Country:US
Mailing Address - Phone:203-892-2601
Mailing Address - Fax:
Practice Address - Street 1:725 PARK AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4619
Practice Address - Country:US
Practice Address - Phone:203-366-3653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004827235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist