Provider Demographics
NPI:1194847095
Name:WILLETT, JANEE G (MA)
Entity Type:Individual
Prefix:MRS
First Name:JANEE
Middle Name:G
Last Name:WILLETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN STE B316
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-6890
Mailing Address - Country:US
Mailing Address - Phone:972-566-2738
Mailing Address - Fax:214-566-2662
Practice Address - Street 1:7777 FOREST LN STE 316
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-2738
Practice Address - Fax:214-566-2662
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51476231H00000X
TX91050237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80367AOtherBLUE CROSS BLUE SHIELD
TX8D0273Medicare ID - Type Unspecified