Provider Demographics
NPI:1871786285
Name:PIEL, JANE ELLEN (CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:ELLEN
Last Name:PIEL
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 DRAKEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-4678
Mailing Address - Country:US
Mailing Address - Phone:415-898-9834
Mailing Address - Fax:
Practice Address - Street 1:95 DRAKEWOOD LN
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-4678
Practice Address - Country:US
Practice Address - Phone:415-898-9834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP9290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist