Provider Demographics
NPI:1578890117
Name:SAULL, JANE L (SLP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:L
Last Name:SAULL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:LABERGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2222 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7958
Mailing Address - Country:US
Mailing Address - Phone:800-944-9782
Mailing Address - Fax:610-438-2024
Practice Address - Street 1:1700 NE INDIAN RIVER DR
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-5853
Practice Address - Country:US
Practice Address - Phone:772-225-1355
Practice Address - Fax:772-255-8037
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8047235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist