Provider Demographics
NPI:1205578077
Name:LONG, JULIANN (MA CCC/SLP)
Entity type:Individual
Prefix:
First Name:JULIANN
Middle Name:
Last Name:LONG
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:JULIANN
Other - Middle Name:
Other - Last Name:STEBLINKSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5889 GLEN EAGLES DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-6470
Mailing Address - Country:US
Mailing Address - Phone:216-392-9871
Mailing Address - Fax:
Practice Address - Street 1:1046 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1102
Practice Address - Country:US
Practice Address - Phone:330-764-3877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-7800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist