Provider Demographics
NPI:1144477712
Name:EVANS BERNSTEIN, JANICE ELAINE (MA, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:ELAINE
Last Name:EVANS BERNSTEIN
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 1:32 QUAKER DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1162
Mailing Address - Country:US
Mailing Address - Phone:215-860-3567
Mailing Address - Fax:
Practice Address - Street 1:638 BRANDYWINE PKWY
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4278
Practice Address - Country:US
Practice Address - Phone:610-436-3600
Practice Address - Fax:610-436-3606
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist