Provider Demographics
NPI:1295985562
Name:PIORKOWSKI, JEAN FETZNER (MS ED SLP CCC L)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:FETZNER
Last Name:PIORKOWSKI
Suffix:
Gender:F
Credentials:MS ED SLP CCC L
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:FETZNER
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:4514 WINDSOR SPRING RD
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-5802
Mailing Address - Country:US
Mailing Address - Phone:716-474-4777
Mailing Address - Fax:
Practice Address - Street 1:4514 WINDSOR SPRING RD
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-5802
Practice Address - Country:US
Practice Address - Phone:716-474-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP011416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist