Provider Demographics
NPI:1962890954
Name:BILLIOT, JARI JANIS (SLP)
Entity type:Individual
Prefix:
First Name:JARI
Middle Name:JANIS
Last Name:BILLIOT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 UNION BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:CORAPEAKE
Mailing Address - State:NC
Mailing Address - Zip Code:27926-9627
Mailing Address - Country:US
Mailing Address - Phone:757-204-5704
Mailing Address - Fax:
Practice Address - Street 1:660 UNION BRANCH RD
Practice Address - Street 2:
Practice Address - City:CORAPEAKE
Practice Address - State:NC
Practice Address - Zip Code:27926-9627
Practice Address - Country:US
Practice Address - Phone:757-204-5704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007415235Z00000X
NC12952235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist