Provider Demographics
NPI:1194214023
Name:LOSI, JOANNA KREKEL (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:KREKEL
Last Name:LOSI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12692 VICTORY LAKES LOOP
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-1273
Mailing Address - Country:US
Mailing Address - Phone:703-728-9942
Mailing Address - Fax:
Practice Address - Street 1:15000 GRADUATION DR
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-2576
Practice Address - Country:US
Practice Address - Phone:571-261-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist