Provider Demographics
NPI:1558490334
Name:MAURER, JOAN ELIZABETH (MSCCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:ELIZABETH
Last Name:MAURER
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1935
Mailing Address - Country:US
Mailing Address - Phone:845-358-1140
Mailing Address - Fax:
Practice Address - Street 1:149 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-1935
Practice Address - Country:US
Practice Address - Phone:845-358-1140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002350-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist