Provider Demographics
NPI:1447317979
Name:MORENO, JANA A (SLP)
Entity type:Individual
Prefix:MS
First Name:JANA
Middle Name:A
Last Name:MORENO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:JANA
Other - Middle Name:A
Other - Last Name:CAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6720 W 121ST ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2035
Mailing Address - Country:US
Mailing Address - Phone:913-647-7990
Mailing Address - Fax:913-327-5260
Practice Address - Street 1:6720 W 121ST ST STE 101
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-2035
Practice Address - Country:US
Practice Address - Phone:913-647-7990
Practice Address - Fax:913-327-5260
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1516235Z00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist