Provider Demographics
NPI:1780153254
Name:VALLADARES, JOANNA
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:
Last Name:VALLADARES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 SW 82ND AVE APT 1522
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3233
Mailing Address - Country:US
Mailing Address - Phone:939-219-5639
Mailing Address - Fax:
Practice Address - Street 1:5970 SW 18TH ST STE E6-E7
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7197
Practice Address - Country:US
Practice Address - Phone:303-909-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI35542355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant