Provider Demographics
NPI:1013114123
Name:MCINTIRE, JAYNA ANNETTE (MS, CCC- SLP)
Entity Type:Individual
Prefix:MS
First Name:JAYNA
Middle Name:ANNETTE
Last Name:MCINTIRE
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 1:212 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3016
Mailing Address - Country:US
Mailing Address - Phone:724-463-0820
Mailing Address - Fax:
Practice Address - Street 1:371 BETHEL CHURCH RD
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658-2074
Practice Address - Country:US
Practice Address - Phone:724-593-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008214235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist