Provider Demographics
NPI:1508046483
Name:STEPHENS, JANELL E (SLP)
Entity Type:Individual
Prefix:
First Name:JANELL
Middle Name:E
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 ISAIAH DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-9002
Mailing Address - Country:US
Mailing Address - Phone:337-319-5476
Mailing Address - Fax:
Practice Address - Street 1:202 ISAIAH DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-9002
Practice Address - Country:US
Practice Address - Phone:337-319-5476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006343235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist