Provider Demographics
NPI:1003542499
Name:TRABING, JOANNA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:TRABING
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:MINTZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:464 2ND ST STE 105
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-2015
Mailing Address - Country:US
Mailing Address - Phone:952-401-4242
Mailing Address - Fax:
Practice Address - Street 1:464 2ND ST STE 105
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331-2015
Practice Address - Country:US
Practice Address - Phone:952-401-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist