Provider Demographics
NPI:1639406788
Name:CARBONE, JANET LYNN
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:CARBONE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:LYNN
Other - Last Name:CARBONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA OTR/L
Mailing Address - Street 1:4013 FULFORD ST.
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1236
Mailing Address - Country:US
Mailing Address - Phone:301-774-5339
Mailing Address - Fax:
Practice Address - Street 1:2301 RESEARCH BLVD
Practice Address - Street 2:STE.110
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3204
Practice Address - Country:US
Practice Address - Phone:301-424-5200
Practice Address - Fax:301-424-8063
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD#04091174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist