Provider Demographics
NPI:1467604132
Name:GUGLANI, JOANNA MARIE (MA, CCC-SLP/LIC)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MARIE
Last Name:GUGLANI
Suffix:
Gender:F
Credentials:MA, CCC-SLP/LIC
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:MARIE
Other - Last Name:COLVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP/LIC
Mailing Address - Street 1:134 AUTUMN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921-1850
Mailing Address - Country:US
Mailing Address - Phone:315-945-4226
Mailing Address - Fax:
Practice Address - Street 1:134 AUTUMN RIDGE RD
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-1850
Practice Address - Country:US
Practice Address - Phone:315-945-4226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011221-1235Z00000X
NJ41YS00808900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist