Provider Demographics
NPI:1205280765
Name:SKOGMAN, JOANNA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:SKOGMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N MAIN AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1115
Mailing Address - Country:US
Mailing Address - Phone:210-297-7725
Mailing Address - Fax:
Practice Address - Street 1:730 N MAIN AVE STE 107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1115
Practice Address - Country:US
Practice Address - Phone:210-297-7725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102204235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist