Individual
MS. JOANNA IOANNIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW/LCSW
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
992674
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08105031
—
CO
01
—
1114379112
GROUP NPI
CO
Enumeration date
06/14/2005
Last updated
09/08/2023
Update your record
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