Provider Demographics
NPI:1942423736
Name:FLORSHEIM, JOAN (MS)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:FLORSHEIM
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 COMMONWEALTH AVE
Mailing Address - Street 2:APT 311
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-2804
Mailing Address - Country:US
Mailing Address - Phone:617-236-5952
Mailing Address - Fax:617-266-4802
Practice Address - Street 1:390 COMMONWEALTH AVE
Practice Address - Street 2:APT 311
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2804
Practice Address - Country:US
Practice Address - Phone:617-236-5952
Practice Address - Fax:617-266-4802
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA788235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist