Provider Demographics
NPI:1801213517
Name:GIFFIN, JANICE LYNN
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LYNN
Last Name:GIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7522 PEACHMONT AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-5831
Mailing Address - Country:US
Mailing Address - Phone:740-398-8565
Mailing Address - Fax:
Practice Address - Street 1:3057 CLEVELAND AVE SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44707-3625
Practice Address - Country:US
Practice Address - Phone:740-484-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist