Provider Demographics
NPI:1326051061
Name:HARDING, JANIS L (MSCCC-LSP)
Entity Type:Individual
Prefix:MS
First Name:JANIS
Middle Name:L
Last Name:HARDING
Suffix:
Gender:F
Credentials:MSCCC-LSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1086
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-1086
Mailing Address - Country:US
Mailing Address - Phone:708-699-5292
Mailing Address - Fax:708-596-4224
Practice Address - Street 1:154 E 162ND LN
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2197
Practice Address - Country:US
Practice Address - Phone:708-699-5292
Practice Address - Fax:708-596-4224
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1634720OtherBLUE CROSS BLUE SHIELD