Provider Demographics
NPI:1760529630
Name:TAAFFE, JANIS A (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:A
Last Name:TAAFFE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12028 DISTANT THUNDER TRAIL
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1689
Mailing Address - Country:US
Mailing Address - Phone:410-531-9379
Mailing Address - Fax:410-531-9379
Practice Address - Street 1:12028 DISTANT THUNDER TRL
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1689
Practice Address - Country:US
Practice Address - Phone:410-531-9379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0000102042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer