Provider Demographics
NPI:1053852053
Name:SCHWARTZ, JOAN K (SLP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:K
Last Name:SCHWARTZ
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 1:8276 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3715
Mailing Address - Country:US
Mailing Address - Phone:954-610-9311
Mailing Address - Fax:
Practice Address - Street 1:8276 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3715
Practice Address - Country:US
Practice Address - Phone:954-610-9311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA-16718235Z00000X
CT000862235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist