Provider Demographics
NPI:1568677813
Name:CASSETTARI, JANET KATHRYN (MSCCCSLPL)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:KATHRYN
Last Name:CASSETTARI
Suffix:
Gender:F
Credentials:MSCCCSLPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-3320
Mailing Address - Country:US
Mailing Address - Phone:815-274-8506
Mailing Address - Fax:
Practice Address - Street 1:346 ALANA DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1784
Practice Address - Country:US
Practice Address - Phone:815-462-0514
Practice Address - Fax:815-462-3993
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
09137027OtherASHA CERTIFICATION