Provider Demographics
NPI:1578684353
Name:HALL, JANET (MSSLP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:MSSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 J MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42276-9753
Mailing Address - Country:US
Mailing Address - Phone:270-726-3286
Mailing Address - Fax:
Practice Address - Street 1:554 J MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:KY
Practice Address - Zip Code:42276-9753
Practice Address - Country:US
Practice Address - Phone:270-726-3286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY805235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist