Provider Demographics
NPI:1235235441
Name:GASCH, JANIS WOLFE (AUD)
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:WOLFE
Last Name:GASCH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7574 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741
Mailing Address - Country:US
Mailing Address - Phone:520-742-2845
Mailing Address - Fax:520-742-3881
Practice Address - Street 1:7574 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741
Practice Address - Country:US
Practice Address - Phone:520-742-2845
Practice Address - Fax:520-742-3881
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA519231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00171230OtherRAILROAD MEDICARE
AZAZ0902070OtherBCBS OF ARIZONA
AZZ69046Medicare UPIN