Provider Demographics
NPI:1508837808
Name:COMRIE, JOAN D (SLP)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:D
Last Name:COMRIE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 1ST ST W
Mailing Address - Street 2:
Mailing Address - City:TIERRA VERDE
Mailing Address - State:FL
Mailing Address - Zip Code:33715-1702
Mailing Address - Country:US
Mailing Address - Phone:727-317-7655
Mailing Address - Fax:727-279-4977
Practice Address - Street 1:9500 KOGER BLVD N STE 213
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-2466
Practice Address - Country:US
Practice Address - Phone:727-217-5023
Practice Address - Fax:727-279-4977
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA14043235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0270VOtherBCBS
NC7210602Medicaid