Provider Demographics
NPI:1407091986
Name:ROMANO, JOANNA LYNN (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:LYNN
Last Name:ROMANO
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MRS
Other - First Name:JOANNA
Other - Middle Name:LYNN
Other - Last Name:SCOUTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:2 HAVERHILL PL
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:NY
Mailing Address - Zip Code:13214-2422
Mailing Address - Country:US
Mailing Address - Phone:315-391-2798
Mailing Address - Fax:
Practice Address - Street 1:1 ADLER DR
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-1223
Practice Address - Country:US
Practice Address - Phone:315-468-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016139-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist