Provider Demographics
NPI:1326277310
Name:FEDDERS, JANICE M
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:FEDDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ANDREWS ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02019-2302
Mailing Address - Country:US
Mailing Address - Phone:508-883-7860
Mailing Address - Fax:508-883-7860
Practice Address - Street 1:20 ANDREWS ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-2302
Practice Address - Country:US
Practice Address - Phone:508-883-7860
Practice Address - Fax:508-883-7860
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3516235Z00000X
RISP00364235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist