Provider Demographics
NPI:1407153661
Name:HELLREICH, JANICE MIRIAM (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:MIRIAM
Last Name:HELLREICH
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MRS
Other - First Name:JANICE
Other - Middle Name:MIRIAM
Other - Last Name:HELLREICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SPEECH PATHOLOGIST
Mailing Address - Street 1:40 AULIKE ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2758
Mailing Address - Country:US
Mailing Address - Phone:808-284-3235
Mailing Address - Fax:808-262-9222
Practice Address - Street 1:40 AULIKE ST
Practice Address - Street 2:SUITE 311
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2758
Practice Address - Country:US
Practice Address - Phone:808-284-3235
Practice Address - Fax:808-262-9222
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000062059OtherHMSA