Provider Demographics
NPI:1588934095
Name:OLDAK, JANET GENEVIEVE (SLP, CCC MA)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:GENEVIEVE
Last Name:OLDAK
Suffix:
Gender:F
Credentials:SLP, CCC MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PEMBROKE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-6318
Mailing Address - Country:US
Mailing Address - Phone:732-534-5693
Mailing Address - Fax:
Practice Address - Street 1:14 PEMBROKE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-6318
Practice Address - Country:US
Practice Address - Phone:732-534-5693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-01
Last Update Date:2012-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00114900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist