Provider Demographics
NPI:1588816979
Name:BALLARD, JANET MARIE (JANET BALLARD, SLP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:BALLARD
Suffix:
Gender:F
Credentials:JANET BALLARD, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SUGARLOAF KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33042-3511
Mailing Address - Country:US
Mailing Address - Phone:410-903-1972
Mailing Address - Fax:
Practice Address - Street 1:5220 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4302
Practice Address - Country:US
Practice Address - Phone:305-295-0265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9651235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist