Provider Demographics
NPI:1477953289
Name:CHACLAS, JEANNE ELIZABETH (CSCD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:ELIZABETH
Last Name:CHACLAS
Suffix:
Gender:F
Credentials:CSCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WINTER HILL RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1484
Mailing Address - Country:US
Mailing Address - Phone:774-437-1424
Mailing Address - Fax:
Practice Address - Street 1:1078 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEICESTER
Practice Address - State:MA
Practice Address - Zip Code:01524-1396
Practice Address - Country:US
Practice Address - Phone:508-406-9256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9661235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist