Provider Demographics
NPI:1841675410
Name:KLINE, JORJANN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:JORJANN
Middle Name:
Last Name:KLINE
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 1:110 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5677
Mailing Address - Country:US
Mailing Address - Phone:907-561-1478
Mailing Address - Fax:888-552-1720
Practice Address - Street 1:110 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5677
Practice Address - Country:US
Practice Address - Phone:907-561-1478
Practice Address - Fax:888-552-1720
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK102048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist