Provider Demographics
NPI:1609029321
Name:LOH, JANE MARIE (MA, CCC-SLP, COM)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:MARIE
Last Name:LOH
Suffix:
Gender:F
Credentials:MA, CCC-SLP, COM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 BLACK ROCK TPKE # 337
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-2400
Mailing Address - Country:US
Mailing Address - Phone:914-261-3518
Mailing Address - Fax:
Practice Address - Street 1:108 OLD KINGS HWY N
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-3615
Practice Address - Country:US
Practice Address - Phone:914-261-3518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017750-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist