Healthcare Provider Details

I. General information

NPI: 1174811756
Provider Name (Legal Business Name): JANICE VOTTA M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NEW RIVER RD APT 411
MANVILLE RI
02838-1814
US

IV. Provider business mailing address

400 NEW RIVER RD APT 411
MANVILLE RI
02838-1814
US

V. Phone/Fax

Practice location:
  • Phone: 508-254-9715
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP00566
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: