Provider Demographics
NPI:1508373713
Name:KLOPACK, JANICE LARENE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LARENE
Last Name:KLOPACK
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 1:2412 TIMBERCREEK DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3190
Mailing Address - Country:US
Mailing Address - Phone:972-839-0654
Mailing Address - Fax:
Practice Address - Street 1:265 PLATEAU DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1328
Practice Address - Country:US
Practice Address - Phone:469-777-8997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist