Provider Demographics
NPI:1871614040
Name:SZYMBERSKI, JOAN DIANNE
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:DIANNE
Last Name:SZYMBERSKI
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 1:1514 LAKE HEATHER RESERVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7628
Mailing Address - Country:US
Mailing Address - Phone:205-566-5829
Mailing Address - Fax:
Practice Address - Street 1:160 YACHT CLUB WAY
Practice Address - Street 2:APT. 209
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-6022
Practice Address - Country:US
Practice Address - Phone:205-566-5829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 8855235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist