Provider Demographics
NPI:1861817280
Name:HOUSE, JANET (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:HOUSE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 BLACKBROOK RD
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-1294
Mailing Address - Country:US
Mailing Address - Phone:440-350-2563
Mailing Address - Fax:
Practice Address - Street 1:8140 AUBURN RD
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-9179
Practice Address - Country:US
Practice Address - Phone:440-358-8052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP6153235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist