Provider Demographics
NPI:1821305343
Name:FOGLEMAN, JANA D (MCD)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:D
Last Name:FOGLEMAN
Suffix:
Gender:F
Credentials:MCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 ALBANY CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-3813
Mailing Address - Country:US
Mailing Address - Phone:504-858-8523
Mailing Address - Fax:
Practice Address - Street 1:1904 ORMOND BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-3828
Practice Address - Country:US
Practice Address - Phone:504-388-1601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1874235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist