Provider Demographics
NPI:1619559499
Name:LOMANNO, JUSTINE MICHELE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:MICHELE
Last Name:LOMANNO
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 1:26 ASHWORTH RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-1223
Mailing Address - Country:US
Mailing Address - Phone:617-549-6256
Mailing Address - Fax:
Practice Address - Street 1:1 RANDALL SQ STE 302
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2773
Practice Address - Country:US
Practice Address - Phone:401-443-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty