Provider Demographics
NPI:1871906016
Name:PORTER, JULIE ANN (AUD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:PORTER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:STEFANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:790 COLLEGE PKWY
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-3007
Mailing Address - Country:US
Mailing Address - Phone:802-847-3970
Mailing Address - Fax:802-847-5880
Practice Address - Street 1:790 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3007
Practice Address - Country:US
Practice Address - Phone:802-847-3970
Practice Address - Fax:802-847-5880
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT8054487231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist