Provider Demographics
NPI:1215353859
Name:SPIELVOGEL, JOANNA HELENE (PHD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:HELENE
Last Name:SPIELVOGEL
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 CLARENCE SECREST RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-8055
Mailing Address - Country:US
Mailing Address - Phone:704-999-7173
Mailing Address - Fax:
Practice Address - Street 1:1424 CLARENCE SECREST RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-8055
Practice Address - Country:US
Practice Address - Phone:704-999-7173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6872235Z00000X
NC13172235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist