Provider Demographics
NPI:1407402498
Name:TWARDOCK, JOYCE G (MS-CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:G
Last Name:TWARDOCK
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 1:1345 CALAMUS LN
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3519
Mailing Address - Country:US
Mailing Address - Phone:847-223-1360
Mailing Address - Fax:
Practice Address - Street 1:882 W NIPPERSINK RD
Practice Address - Street 2:
Practice Address - City:ROUND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60073-3701
Practice Address - Country:US
Practice Address - Phone:847-867-1895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty