Janene Noelle Gough
Individual provider Active NPI Speech-Language Pathologist · Santa Clara, UT
NPI 1104650258 · NPPES record last updated Aug 30, 2024
Key facts
- NPI
- 1104650258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 2500 Arch Cir
Santa Clara, UT 84765-5538 - Phone
- (435) 632-3551
- NPI assigned
- Aug 30, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
2500 Arch Cir
Santa Clara, UT 84765-5538
Mailing address
2500 Arch Cir
Santa Clara, UT 84765-5538
Phone (435) 632-3551
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All providers in Santa Clara, UT · Speech-Language Pathologist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.