Provider Demographics
NPI:1528035813
Name:LASKER, JOANNE PATTI (PHD, CCC-SLP)
Entity Type:Individual
Prefix:PROF
First Name:JOANNE
Middle Name:PATTI
Last Name:LASKER
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W 10TH WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32331-7323
Mailing Address - Country:US
Mailing Address - Phone:850-644-8465
Mailing Address - Fax:
Practice Address - Street 1:415 W 10TH WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:FL
Practice Address - Zip Code:32331-7323
Practice Address - Country:US
Practice Address - Phone:850-644-8465
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5893235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist