Provider Demographics
NPI:1588979405
Name:FLOYD, JOANNA J (MED CCC-SLP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:J
Last Name:FLOYD
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 FOUNTAIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CUTHBERT
Mailing Address - State:GA
Mailing Address - Zip Code:39840-3263
Mailing Address - Country:US
Mailing Address - Phone:229-938-8667
Mailing Address - Fax:220-800-8042
Practice Address - Street 1:99 PLUM ST
Practice Address - Street 2:
Practice Address - City:CUTHBERT
Practice Address - State:GA
Practice Address - Zip Code:39840-5808
Practice Address - Country:US
Practice Address - Phone:229-938-8667
Practice Address - Fax:220-800-8042
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007399235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist