Provider Demographics
NPI:1174643241
Name:CHARBONNEAU, JANINE MARY (MS CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:MARY
Last Name:CHARBONNEAU
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:MISS
Other - First Name:JANINE
Other - Middle Name:MARY
Other - Last Name:DRAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:12 BILLINGS ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-4803
Mailing Address - Country:US
Mailing Address - Phone:508-967-7049
Mailing Address - Fax:
Practice Address - Street 1:863 HATHAWAY RD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-1916
Practice Address - Country:US
Practice Address - Phone:508-996-6763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist