Provider Demographics
NPI:1962604280
Name:MONACO, JOAN MARGARET (MS CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:MARGARET
Last Name:MONACO
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 1:3719 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-3826
Mailing Address - Country:US
Mailing Address - Phone:414-744-5079
Mailing Address - Fax:
Practice Address - Street 1:3719 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-3826
Practice Address - Country:US
Practice Address - Phone:414-744-5079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI840-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist