Provider Demographics
NPI:1780167502
Name:EVAN, DELANEY JANE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:DELANEY
Middle Name:JANE
Last Name:EVAN
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 1:5637 STATE ROUTE 46
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9663
Mailing Address - Country:US
Mailing Address - Phone:330-240-5762
Mailing Address - Fax:
Practice Address - Street 1:410 W 7TH ST
Practice Address - Street 2:
Practice Address - City:MC DONALD
Practice Address - State:OH
Practice Address - Zip Code:44437-1606
Practice Address - Country:US
Practice Address - Phone:330-530-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist