Provider Demographics
NPI:1104274299
Name:DILDINE, JANET (MA, CCC -SLP)
Entity type:Individual
Prefix:MISS
First Name:JANET
Middle Name:
Last Name:DILDINE
Suffix:
Gender:F
Credentials:MA, CCC -SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4148 CHATHAM CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-0023
Mailing Address - Country:US
Mailing Address - Phone:919-774-7014
Mailing Address - Fax:
Practice Address - Street 1:135 CHATHAM ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4335
Practice Address - Country:US
Practice Address - Phone:919-774-1281
Practice Address - Fax:919-764-1282
Is Sole Proprietor?:No
Enumeration Date:2016-05-30
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4954235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist