Provider Demographics
NPI:1417001504
Name:MASTERS, JANIS MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:MICHELLE
Last Name:MASTERS
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 1:2824 TIMBERCREEK DR
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-8102
Mailing Address - Country:US
Mailing Address - Phone:501-847-8810
Mailing Address - Fax:
Practice Address - Street 1:2824 TIMBERCREEK DR
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-8102
Practice Address - Country:US
Practice Address - Phone:501-847-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist