Provider Demographics
NPI:1568631869
Name:ACEVEDO, JANINE (MECSE)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:MECSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ECHO AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2417
Mailing Address - Country:US
Mailing Address - Phone:978-927-7070
Mailing Address - Fax:
Practice Address - Street 1:6 ECHO AVE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2417
Practice Address - Country:US
Practice Address - Phone:978-927-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 235500000X
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist