Provider Demographics
NPI:1356597439
Name:RINASZ, JOANNA SUZANNE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:SUZANNE
Last Name:RINASZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:JOANNA
Other - Middle Name:SUZANNE
Other - Last Name:COYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC, SLP
Mailing Address - Street 1:149 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-1434
Mailing Address - Country:US
Mailing Address - Phone:585-377-2230
Mailing Address - Fax:585-377-2312
Practice Address - Street 1:149 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-1434
Practice Address - Country:US
Practice Address - Phone:585-377-2230
Practice Address - Fax:585-377-2312
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017751-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY017751-1Medicaid