Provider Demographics
NPI:1811186638
Name:CHANEY, JAN D (SLP)
Entity Type:Individual
Prefix:MS
First Name:JAN
Middle Name:D
Last Name:CHANEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22593 THREE NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:MD
Mailing Address - Zip Code:20619-3054
Mailing Address - Country:US
Mailing Address - Phone:301-862-2505
Mailing Address - Fax:301-862-2548
Practice Address - Street 1:22593 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MD
Practice Address - Zip Code:20619
Practice Address - Country:US
Practice Address - Phone:301-862-2505
Practice Address - Fax:301-862-2548
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02872235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist