Provider Demographics
NPI:1710054382
Name:KING, JOANNA JEAN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:JEAN
Last Name:KING
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MS
Other - First Name:JOANNA
Other - Middle Name:JEAN
Other - Last Name:SHERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:96 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-5153
Mailing Address - Country:US
Mailing Address - Phone:401-597-5646
Mailing Address - Fax:401-767-4860
Practice Address - Street 1:96 2ND AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-5153
Practice Address - Country:US
Practice Address - Phone:401-597-5646
Practice Address - Fax:401-767-4860
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI309196OtherBC BS
RIKC02260Medicaid
RI4224OtherNEIGHBORHOOD HEALTH
RI413058OtherBLUE CHIP
RI4600187OtherUNITED HEALTHCARE