Provider Demographics
NPI:1992089551
Name:SWANSON, JOY R (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JOY
Middle Name:R
Last Name:SWANSON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BLUEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356-8653
Mailing Address - Country:US
Mailing Address - Phone:717-501-6083
Mailing Address - Fax:
Practice Address - Street 1:55 BLUEBERRY LN
Practice Address - Street 2:
Practice Address - City:RED LION
Practice Address - State:PA
Practice Address - Zip Code:17356-8653
Practice Address - Country:US
Practice Address - Phone:717-501-6083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012657235Z00000X
NJ41YS00617000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist