Basic Information
| Provider Information | |||||||||
| NPI: | 1023154382 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHAPIRO | ||||||||
| FirstName: | JANINE | ||||||||
| MiddleName: | YAEL | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | SLP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | RACHMAN | ||||||||
| OtherFirstName: | JANINE | ||||||||
| OtherMiddleName: | YAEL | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7901 E 88TH ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462561235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178495437 | ||||||||
| FaxNumber: | 3178425911 | ||||||||
| Practice Location | |||||||||
| Address1: | 7901 E 88TH ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462561235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178495437 | ||||||||
| FaxNumber: | 3178425911 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 04/26/2011 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 24908 | TX | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 103K00000X | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 235Z00000X | 22004700A | IN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.