Provider Demographics
NPI:1346068988
Name:JOIS, SUPRABHA
Entity type:Individual
Prefix:MRS
First Name:SUPRABHA
Middle Name:
Last Name:JOIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3262 CHESTNUT OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6614
Mailing Address - Country:US
Mailing Address - Phone:770-312-4736
Mailing Address - Fax:
Practice Address - Street 1:4236 TILLY MILL RD
Practice Address - Street 2:
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30360-3112
Practice Address - Country:US
Practice Address - Phone:770-312-4736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005806235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist