Provider Demographics
NPI:1942410071
Name:YACOVONI, JANET (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:YACOVONI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 PARKHURST CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7098
Mailing Address - Country:US
Mailing Address - Phone:972-318-1188
Mailing Address - Fax:
Practice Address - Street 1:3201 PARKHURST CIR
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7098
Practice Address - Country:US
Practice Address - Phone:972-318-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19989235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist