Provider Demographics
NPI:1922795384
Name:MILLETT, JANE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:MILLETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 CROWNE SPRINGS CIR UNIT 307
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-8148
Mailing Address - Country:US
Mailing Address - Phone:606-269-2281
Mailing Address - Fax:
Practice Address - Street 1:1701 FRANKFORT RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-9451
Practice Address - Country:US
Practice Address - Phone:502-633-2344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY284494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist