Provider Demographics
NPI:1750642799
Name:HALL, JANET L (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:HALL
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 N 4425
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:OK
Mailing Address - Zip Code:74365-2096
Mailing Address - Country:US
Mailing Address - Phone:918-694-8059
Mailing Address - Fax:918-434-2121
Practice Address - Street 1:92 N 4425
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:OK
Practice Address - Zip Code:74365-2096
Practice Address - Country:US
Practice Address - Phone:918-694-8059
Practice Address - Fax:918-434-2121
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK811235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist