Provider Demographics
NPI:1760638969
Name:KORMAN, JOAN E (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:E
Last Name:KORMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 RAYE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-7505
Mailing Address - Country:US
Mailing Address - Phone:518-526-6971
Mailing Address - Fax:
Practice Address - Street 1:138 RAYE DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-7505
Practice Address - Country:US
Practice Address - Phone:518-526-6971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007807235Z00000X
NC10645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist