Provider Demographics
NPI:1083906903
Name:LOVETT, JEAN M (SLP)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:M
Last Name:LOVETT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8658 ELMER HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-9313
Mailing Address - Country:US
Mailing Address - Phone:315-337-2055
Mailing Address - Fax:
Practice Address - Street 1:8658 ELMER HILL RD
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-9313
Practice Address - Country:US
Practice Address - Phone:315-337-2055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006576-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist