Provider Demographics
NPI:1952757510
Name:WAHMANN, JOANNA
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:WAHMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:MAFFIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:8804 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5902
Mailing Address - Country:US
Mailing Address - Phone:646-331-5495
Mailing Address - Fax:
Practice Address - Street 1:8804 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5902
Practice Address - Country:US
Practice Address - Phone:718-238-2765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007033225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics