Provider Demographics
NPI:1700180718
Name:MARIANO, JANET (MA,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:MARIANO
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 SOUTH POST ROAD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3211
Mailing Address - Country:US
Mailing Address - Phone:609-890-4510
Mailing Address - Fax:
Practice Address - Street 1:384 S POST RD
Practice Address - Street 2:
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-3211
Practice Address - Country:US
Practice Address - Phone:609-890-4510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00015600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ41YS00015600OtherNEW JERSEY LICENSE SPEECH LANGUAGE PATHOLOGIST