Provider Demographics
NPI:1326291014
Name:MECHANIC, JANIS B (MS CCC-SP)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:B
Last Name:MECHANIC
Suffix:
Gender:F
Credentials:MS CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 W APPLE TREE RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-3310
Mailing Address - Country:US
Mailing Address - Phone:414-350-0626
Mailing Address - Fax:414-351-0486
Practice Address - Street 1:2228 W APPLE TREE RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-3310
Practice Address - Country:US
Practice Address - Phone:414-350-0626
Practice Address - Fax:414-351-0486
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI139-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist