Provider Demographics
NPI:1164756698
Name:JAMES, JANINE ELAINE (MED CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:ELAINE
Last Name:JAMES
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4673 CREEKSIDE CV
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-3936
Mailing Address - Country:US
Mailing Address - Phone:404-209-2987
Mailing Address - Fax:
Practice Address - Street 1:4673 CREEKSIDE CV
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-3936
Practice Address - Country:US
Practice Address - Phone:404-209-2987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006114235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist