Provider Demographics
NPI:1174777460
Name:IOANNOU, JOANNE (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:IOANNOU
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1476 163RD ST
Mailing Address - Street 2:
Mailing Address - City:BEECHHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2913
Mailing Address - Country:US
Mailing Address - Phone:917-929-1741
Mailing Address - Fax:
Practice Address - Street 1:1476 163RD ST
Practice Address - Street 2:
Practice Address - City:BEECHHURST
Practice Address - State:NY
Practice Address - Zip Code:11357-2913
Practice Address - Country:US
Practice Address - Phone:917-929-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010986-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist