Provider Demographics
NPI:1497188171
Name:DORTON, JANA SUSAN
Entity Type:Individual
Prefix:MRS
First Name:JANA
Middle Name:SUSAN
Last Name:DORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JANA
Other - Middle Name:SUSAN
Other - Last Name:GREENHAGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6444 MONROE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1454
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6444 MONROE ST
Practice Address - Street 2:SUITE B
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-1454
Practice Address - Country:US
Practice Address - Phone:419-873-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2013208235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist