Provider Demographics
NPI:1992147045
Name:GAUGER, JAYNE JONES (MA CCC SLP L)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:JONES
Last Name:GAUGER
Suffix:
Gender:F
Credentials:MA CCC SLP L
Other - Prefix:
Other - First Name:JAYNE
Other - Middle Name:MARIE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:713 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-2417
Mailing Address - Country:US
Mailing Address - Phone:610-823-4034
Mailing Address - Fax:
Practice Address - Street 1:713 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-2417
Practice Address - Country:US
Practice Address - Phone:610-823-4034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009937235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist