Provider Demographics
NPI:1306335377
Name:KAWA, JOANNA C (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:C
Last Name:KAWA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 BERMUDA HUNDRED RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-3108
Mailing Address - Country:US
Mailing Address - Phone:804-393-8585
Mailing Address - Fax:
Practice Address - Street 1:1001 CEDAR FORK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-2213
Practice Address - Country:US
Practice Address - Phone:804-393-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-06
Last Update Date:2018-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002921235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist