Provider Demographics
NPI:1487036018
Name:MAVRIS, JOANNA F
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:F
Last Name:MAVRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 W PINNACLE PEAK RD STE 170
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-1224
Mailing Address - Country:US
Mailing Address - Phone:480-807-6335
Mailing Address - Fax:
Practice Address - Street 1:1155 S POWER RD STE 109
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3716
Practice Address - Country:US
Practice Address - Phone:480-807-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8841237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist