Joanna M Bagg, M.A.

Individual provider Active NPI Speech-Language Pathologist · Fort White, FL

NPI 1982840583 · NPPES record last updated May 19, 2015

Key facts

NPI
1982840583
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
655 SW Pathfinder GLN
Fort White, FL 32038-8003
Phone
(352) 301-9035
NPI assigned
Jan 2, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X FL Yes

Addresses

Primary practice location

655 SW Pathfinder GLN
Fort White, FL 32038-8003

Mailing address

655 SW Pathfinder GLN
Fort White, FL 32038-8003
Phone (352) 301-9035

Other providers in Fort White, FL

All providers in Fort White, FL · Speech-Language Pathologist in Florida

Sources for this page

Verify at the official NPI Registry.