Provider Demographics
NPI:1700225034
Name:JANUARY, SHENNELL (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHENNELL
Middle Name:
Last Name:JANUARY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13785 LYNN ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-2125
Mailing Address - Country:US
Mailing Address - Phone:703-595-5972
Mailing Address - Fax:
Practice Address - Street 1:13785 LYNN ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-2125
Practice Address - Country:US
Practice Address - Phone:703-595-5972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist