=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821375122
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANYCE ELIZABETH MELTZER M.S.CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2011
-----------------------------------------------------
Last Update Date | 11/15/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11021 LEGACY LN SUITE 104
-----------------------------------------------------
City | PALM BEACH GARDENS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33410-3615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-603-8990
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11021 LEGACY LN SUITE 104
-----------------------------------------------------
City | PALM BEACH GARDENS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33410-3615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-603-8990
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SA3856
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------