Provider Demographics
NPI:1235173634
Name:SMITH, JOANN MARIA
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:MARIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:MARIA
Other - Last Name:KULWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:61 W AURORA RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2003
Mailing Address - Country:US
Mailing Address - Phone:330-467-4130
Mailing Address - Fax:330-467-4131
Practice Address - Street 1:61 W AURORA RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-2003
Practice Address - Country:US
Practice Address - Phone:330-467-4130
Practice Address - Fax:330-467-4131
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00343231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist