Provider Demographics
NPI:1417709452
Name:DUNCAN, JANICE JILL
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:JILL
Last Name:DUNCAN
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 1:12273 GA HIGHWAY 24 E
Mailing Address - Street 2:
Mailing Address - City:DAVISBORO
Mailing Address - State:GA
Mailing Address - Zip Code:31018-5824
Mailing Address - Country:US
Mailing Address - Phone:478-357-2208
Mailing Address - Fax:
Practice Address - Street 1:12273 GA HIGHWAY 24 E
Practice Address - Street 2:
Practice Address - City:DAVISBORO
Practice Address - State:GA
Practice Address - Zip Code:31018-5824
Practice Address - Country:US
Practice Address - Phone:478-357-2208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003725235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist