Provider Demographics
NPI:1356715718
Name:LAGNO, JOAN (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:LAGNO
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 1:80 HIGHMEADOW RD
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-1532
Mailing Address - Country:US
Mailing Address - Phone:860-417-9428
Mailing Address - Fax:
Practice Address - Street 1:80 HIGHMEADOW RD
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-1532
Practice Address - Country:US
Practice Address - Phone:860-417-9428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000829235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist