Provider Demographics
NPI:1003077454
Name:DILLON, JOANNE FAYE (MS, CCC-A, FAAA)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:FAYE
Last Name:DILLON
Suffix:
Gender:F
Credentials:MS, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 W MAIN ST STE G
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-1780
Mailing Address - Country:US
Mailing Address - Phone:540-731-4327
Mailing Address - Fax:540-731-4328
Practice Address - Street 1:616 W MAIN ST STE G
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-1780
Practice Address - Country:US
Practice Address - Phone:540-731-4327
Practice Address - Fax:540-731-4328
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA220100117237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1427283043Medicare PIN