Provider Demographics
NPI:1790063188
Name:GIBBS, JANEE ROGERS (MCD,SLP,CF)
Entity Type:Individual
Prefix:
First Name:JANEE
Middle Name:ROGERS
Last Name:GIBBS
Suffix:
Gender:F
Credentials:MCD,SLP,CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WINCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:LA
Mailing Address - Zip Code:70374-4322
Mailing Address - Country:US
Mailing Address - Phone:985-632-7919
Mailing Address - Fax:985-632-3581
Practice Address - Street 1:104 W 134TH ST
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-4155
Practice Address - Country:US
Practice Address - Phone:985-632-7919
Practice Address - Fax:985-632-3581
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6462235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist