MEDICARE: DR. JOANNA HELENE SPIELVOGEL PHD, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	6872	SC
2	235Z00000X	Speech-Language Pathologist	13172	NC

General Provider Information

NPI Number	:	1215353859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOANNA HELENE SPIELVOGEL PHD, CCC-SLP

Provider Business Mailing Address
First Line	:	1424 CLARENCE SECREST RD
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28110-8055
Country	:	US
Telephone Number	:	704-999-7173
Fax Number	:

Provider Business Practice Location Address
First Line	:	1424 CLARENCE SECREST RD
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28110-8055
Country	:	US
Telephone Number	:	704-999-7173
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2014
Last Update Date	:	07/30/2020

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Directions to “ DR. JOANNA HELENE SPIELVOGEL PHD, CCC-SLP” Practice Location

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