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NPI Code Detail

MEDICARE: JANELLE LIBRETTO CCC-SLP

MEDICARE: JANELLE LIBRETTO CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist10363NC

General Provider Information

NPI Number : 1083058960
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANELLE LIBRETTO CCC-SLP
Provider Business Mailing Address
First Line : 5919 OLEANDER DR
Second Line : 119
City : WILMINGTON
State : NC
Zip : 28403-4780
Country : US
Telephone Number : 910-395-2995
Fax Number : 910-313-0951
Provider Business Practice Location Address
First Line : 58 OFFICE PARK DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-3218
Country : US
Telephone Number : 910-353-2440
Fax Number : 910-219-7727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2013
Last Update Date : 04/23/2013

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Directions to “ JANELLE LIBRETTO CCC-SLP” Practice Location

Language Start Address Practice Location
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