Provider Demographics
NPI:1518139229
Name:PRIMONT, JOANNA MCGILL (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MCGILL
Last Name:PRIMONT
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 1:10 HAMILTONIAN DR
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5011
Mailing Address - Country:US
Mailing Address - Phone:917-435-4892
Mailing Address - Fax:
Practice Address - Street 1:10 HAMILTONIAN DR
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5011
Practice Address - Country:US
Practice Address - Phone:917-435-4892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9105235Z00000X
NY016877-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist