Provider Demographics
NPI:1356657712
Name:AGUIRRE, JANET MARIE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:MARIE
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 HERVEY STREET RD
Mailing Address - Street 2:
Mailing Address - City:CORNWALLVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12418-1316
Mailing Address - Country:US
Mailing Address - Phone:518-634-7741
Mailing Address - Fax:
Practice Address - Street 1:2 BETHLEHEM CT
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1306
Practice Address - Country:US
Practice Address - Phone:518-478-0722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005495-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist