Provider Demographics
NPI:1942362819
Name:HARVEY, JANE H (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:H
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 GEORGETOWN DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-3017
Mailing Address - Country:US
Mailing Address - Phone:706-549-1296
Mailing Address - Fax:
Practice Address - Street 1:110 CARLTON ST.
Practice Address - Street 2:ADERHOLD HALL, UNIVERSITY OF GEORGIA
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-7154
Practice Address - Country:US
Practice Address - Phone:706-542-4587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP000191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist