Provider Demographics
NPI:1013205269
Name:CLAUS, JEANETTE DOYLE (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:DOYLE
Last Name:CLAUS
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 1:2444 SW OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2035
Mailing Address - Country:US
Mailing Address - Phone:772-463-4684
Mailing Address - Fax:
Practice Address - Street 1:2444 SW OAK RIDGE RD
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2035
Practice Address - Country:US
Practice Address - Phone:772-463-4684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6129235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist