Provider Demographics
NPI:1477707362
Name:ROCK, JOANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:ROCK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WELWYN RD
Mailing Address - Street 2:APT. 2AB
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3507
Mailing Address - Country:US
Mailing Address - Phone:516-482-3384
Mailing Address - Fax:
Practice Address - Street 1:13 WELWYN RD
Practice Address - Street 2:APT. 2AB
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3507
Practice Address - Country:US
Practice Address - Phone:516-482-3384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000280-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist