Provider Demographics
NPI:1053699926
Name:CASSON, JOYA W (MED, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JOYA
Middle Name:W
Last Name:CASSON
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2797 STONEWALL LN SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8190
Mailing Address - Country:US
Mailing Address - Phone:678-570-5778
Mailing Address - Fax:678-805-5555
Practice Address - Street 1:2797 STONEWALL LN SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-8190
Practice Address - Country:US
Practice Address - Phone:678-570-5778
Practice Address - Fax:678-805-5555
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000875619BMedicaid