Provider Demographics
NPI:1518363589
Name:CHARD, JAN ELIZABETH (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JAN
Middle Name:ELIZABETH
Last Name:CHARD
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4811 KUPREANOF ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1012
Mailing Address - Country:US
Mailing Address - Phone:907-727-5557
Mailing Address - Fax:
Practice Address - Street 1:2150 E DOWLING RD STE C
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1979
Practice Address - Country:US
Practice Address - Phone:907-727-5557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK457235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist