Provider Demographics
NPI:1902314883
Name:GUHIT, JOANNA MARI CONCHA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOANNA MARI
Middle Name:CONCHA
Last Name:GUHIT
Suffix:
Gender:F
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 1:1441 OAK ST STE 4
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7726
Mailing Address - Country:US
Mailing Address - Phone:541-371-2782
Mailing Address - Fax:
Practice Address - Street 1:1441 OAK ST STE 4
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7726
Practice Address - Country:US
Practice Address - Phone:541-371-2782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-13
Last Update Date:2018-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist