Provider Demographics
NPI:1184972796
Name:JUANG, JOYCE FREDA
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:FREDA
Last Name:JUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 MCKINLEY STREET
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822
Mailing Address - Country:US
Mailing Address - Phone:808-546-0407
Mailing Address - Fax:
Practice Address - Street 1:94-408 AKOKI ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2733
Practice Address - Country:US
Practice Address - Phone:808-676-5584
Practice Address - Fax:808-676-5587
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1246235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist