Provider Demographics
NPI:1922499722
Name:PIERSON, JOELLE DAWN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOELLE
Middle Name:DAWN
Last Name:PIERSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21918 W 176TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-8222
Mailing Address - Country:US
Mailing Address - Phone:913-909-8523
Mailing Address - Fax:
Practice Address - Street 1:21918 W 176TH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-8222
Practice Address - Country:US
Practice Address - Phone:913-909-8523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-15
Last Update Date:2015-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2273235Z00000X
MO2003018092235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist