Provider Demographics
NPI:1952366148
Name:CASE, JOANNE ANGELA (CCC SL/P,CERT, AV)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:ANGELA
Last Name:CASE
Suffix:
Gender:F
Credentials:CCC SL/P,CERT, AV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3926
Mailing Address - Country:US
Mailing Address - Phone:973-542-0140
Mailing Address - Fax:
Practice Address - Street 1:208 STRATFORD DR
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3926
Practice Address - Country:US
Practice Address - Phone:973-542-0140
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00264400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist