Provider Demographics
NPI:1538323985
Name:FRANCISCO, JANELLE RAE (MS, ATC)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:RAE
Last Name:FRANCISCO
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 CENTER RD
Mailing Address - Street 2:APT 5D
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4178
Mailing Address - Country:US
Mailing Address - Phone:860-983-0266
Mailing Address - Fax:
Practice Address - Street 1:2111 HILLSIDE RD
Practice Address - Street 2:U-3078
Practice Address - City:STORRS MANSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06269-9002
Practice Address - Country:US
Practice Address - Phone:860-486-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0005552255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer