Provider Demographics
NPI:1952484156
Name:MEROTH, JOANNA SMOCK (MED)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:SMOCK
Last Name:MEROTH
Suffix:
Gender:F
Credentials:MED
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Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7008
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:1132 N CHURCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1039
Practice Address - Country:US
Practice Address - Phone:336-358-4283
Practice Address - Fax:336-335-3160
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2014-08-25
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Provider Licenses
StateLicense IDTaxonomies
NC5746231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1952484156Medicaid
NC1952484156Medicaid