Provider Demographics
NPI:1881197838
Name:HARRINGTON, JOHNA SERENITY (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOHNA
Middle Name:SERENITY
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:JOHNA
Other - Middle Name:SERENITY
Other - Last Name:VANDYKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2800 W GARTON RD
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-9024
Mailing Address - Country:US
Mailing Address - Phone:417-667-1152
Mailing Address - Fax:
Practice Address - Street 1:2800 W GARTON RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-9024
Practice Address - Country:US
Practice Address - Phone:417-667-1152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00934200235Z00000X
MO2015033632235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist