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NPI Code Detail

MEDICARE: JANAYE ARLIVIA JASPER CCC-SLP

MEDICARE:   JANAYE ARLIVIA JASPER  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 PathologistSLP011653GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SLP011653OTHERGASTATE LICENSE

General Provider Information

NPI Number : 1518530138
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANAYE ARLIVIA JASPER CCC-SLP
Provider Business Mailing Address
First Line : 4287 HIGH PARK LN
Second Line :
City : EAST POINT
State : GA
Zip : 30344-7043
Country : US
Telephone Number : 706-766-6605
Fax Number :
Provider Business Practice Location Address
First Line : 4287 HIGH PARK LN
Second Line :
City : EAST POINT
State : GA
Zip : 30344-7043
Country : US
Telephone Number : 706-766-6605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2021
Last Update Date : 09/16/2022

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Directions to “ JANAYE ARLIVIA JASPER CCC-SLP” Practice Location

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