Provider Demographics
NPI:1467503003
Name:MUELLER, JANETTE PAULA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANETTE
Middle Name:PAULA
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MISS
Other - First Name:JANETTE
Other - Middle Name:PAULA
Other - Last Name:FREDERICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:210 LIBERTY HILL RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2442
Mailing Address - Country:US
Mailing Address - Phone:910-272-9056
Mailing Address - Fax:901-272-9057
Practice Address - Street 1:518 LIBERTY HILL RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2448
Practice Address - Country:US
Practice Address - Phone:910-272-9056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412605Medicaid