Provider Demographics
NPI:1114933389
Name:WRIGHT, JANINE LAFRANCE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:LAFRANCE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:JANINE
Other - Middle Name:LAFRANCE
Other - Last Name:WALTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:905 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-4632
Mailing Address - Country:US
Mailing Address - Phone:770-837-5775
Mailing Address - Fax:770-638-1961
Practice Address - Street 1:1304 ROCKBRIDGE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3138
Practice Address - Country:US
Practice Address - Phone:770-638-3977
Practice Address - Fax:770-638-1961
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005093235Z00000X
FLSA 9758235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000409200Medicaid
GA000936471CMedicaid