Provider Demographics
NPI:1447904149
Name:CAMMARN, JOSHUA RYAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:RYAN
Last Name:CAMMARN
Suffix:
Gender:M
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:PO BOX 470421
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-0421
Mailing Address - Country:US
Mailing Address - Phone:407-815-5226
Mailing Address - Fax:
Practice Address - Street 1:925 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1212
Practice Address - Country:US
Practice Address - Phone:407-237-6387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA20020235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist