Provider Demographics
NPI:1558519009
Name:PETITTE, JANET M (MS CCC/A)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:M
Last Name:PETITTE
Suffix:
Gender:F
Credentials:MS CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 N COMMONS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7940
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:630-303-5385
Practice Address - Street 1:1801 OLD TROLLEY RD STE 101
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8283
Practice Address - Country:US
Practice Address - Phone:843-871-3235
Practice Address - Fax:843-871-3233
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT-005891231H00000X
WVA-0177231H00000X
SC4258231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist