Provider Demographics
NPI:1649396656
Name:MAHONEY, JANET L (PT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:L
Other - Last Name:HALPIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:16623 W RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:INGLIS
Mailing Address - State:FL
Mailing Address - Zip Code:34449-5116
Mailing Address - Country:US
Mailing Address - Phone:978-491-8084
Mailing Address - Fax:
Practice Address - Street 1:63 PARKER RIDGE LANE SUITE 290
Practice Address - Street 2:
Practice Address - City:BLUE HILL
Practice Address - State:ME
Practice Address - Zip Code:04614-2123
Practice Address - Country:US
Practice Address - Phone:833-833-3258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5479174400000X
235Z00000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty