Provider Demographics
NPI:1679878979
Name:POWIS, JANICE TANEDO (AUD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:TANEDO
Last Name:POWIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:JANICE
Other - Middle Name:RIVERA
Other - Last Name:TANEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:215 SHUMAN BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8123
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:630-303-5385
Practice Address - Street 1:3173 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-2124
Practice Address - Country:US
Practice Address - Phone:727-822-2132
Practice Address - Fax:727-821-4248
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA939231H00000X
FLAY2286231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist