Provider Demographics
NPI:1508225103
Name:CAMERON, JOANNA MARIE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:MARIE
Last Name:CAMERON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:MARIE
Other - Last Name:HEFNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:429 DAWSON AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:PA
Mailing Address - Zip Code:15202-3211
Mailing Address - Country:US
Mailing Address - Phone:765-490-2966
Mailing Address - Fax:
Practice Address - Street 1:2400 WILDWOOD RD
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-6404
Practice Address - Country:US
Practice Address - Phone:412-487-7771
Practice Address - Fax:412-487-7772
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist