Provider Demographics
NPI:1528215845
Name:LAROCK, JAYNE ELIZABETH (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JAYNE
Middle Name:ELIZABETH
Last Name:LAROCK
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:MRS
Other - First Name:JAYNE
Other - Middle Name:ELIZABETH
Other - Last Name:BEALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,CCC-SLP
Mailing Address - Street 1:100 MALTON RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NEGAUNEE
Mailing Address - State:MI
Mailing Address - Zip Code:49866-2001
Mailing Address - Country:US
Mailing Address - Phone:906-485-2261
Mailing Address - Fax:906-485-2506
Practice Address - Street 1:100 MALTON RD
Practice Address - Street 2:SUITE 5
Practice Address - City:NEGAUNEE
Practice Address - State:MI
Practice Address - Zip Code:49866-2001
Practice Address - Country:US
Practice Address - Phone:906-485-2261
Practice Address - Fax:906-485-2506
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist