Basic Information
| Provider Information | |||||||||
| NPI: | 1255511762 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOWALSKI | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S, CCC/SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6109 WOODFORD DR | ||||||||
| Address2: | |||||||||
| City: | LAKE VIEW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140859457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163358888 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4242 RIDGE LEA RD | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | AMHERST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142261051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168192400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2007 | ||||||||
| LastUpdateDate: | 08/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 011336-1 | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | 011336 | NY | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.