Provider Demographics
NPI:1215332747
Name:KILMER, JANELLE D (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:D
Last Name:KILMER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:846 E WICONISCO AVE
Mailing Address - Street 2:
Mailing Address - City:TOWER CITY
Mailing Address - State:PA
Mailing Address - Zip Code:17980-1609
Mailing Address - Country:US
Mailing Address - Phone:717-523-1257
Mailing Address - Fax:
Practice Address - Street 1:846 E WICONISCO AVE
Practice Address - Street 2:
Practice Address - City:TOWER CITY
Practice Address - State:PA
Practice Address - Zip Code:17980-1609
Practice Address - Country:US
Practice Address - Phone:717-523-1257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011373235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist