Provider Demographics
NPI:1194975680
Name:JOHANNIS, JOYCE A (SLP)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:JOHANNIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:A
Other - Last Name:MCNIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 TWIN LEAF TRL
Mailing Address - Street 2:
Mailing Address - City:SAUNDERSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02874-2370
Mailing Address - Country:US
Mailing Address - Phone:401-294-4803
Mailing Address - Fax:
Practice Address - Street 1:2 TWIN LEAF TRL
Practice Address - Street 2:
Practice Address - City:SAUNDERSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02874-2370
Practice Address - Country:US
Practice Address - Phone:401-294-4803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00311235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist