Provider Demographics
NPI:1275695736
Name:MACEY, JANEY MARIE (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANEY
Middle Name:MARIE
Last Name:MACEY
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2285 BENTON RD
Mailing Address - Street 2:SUITE C-200
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-7933
Mailing Address - Country:US
Mailing Address - Phone:318-741-5909
Mailing Address - Fax:318-741-5911
Practice Address - Street 1:2285 BENTON RD
Practice Address - Street 2:SUITE C-200
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-7933
Practice Address - Country:US
Practice Address - Phone:318-741-5909
Practice Address - Fax:318-741-5911
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-143103K00000X
LA5027235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty