Provider Demographics
NPI:1871675413
Name:FELTY, JANIS H (SLP)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:H
Last Name:FELTY
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 1:433 FORKS OF THE RIVER PKWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-6921
Mailing Address - Country:US
Mailing Address - Phone:865-365-1230
Mailing Address - Fax:865-365-1232
Practice Address - Street 1:433 FORKS OF THE RIVER PKWY
Practice Address - Street 2:SUITE 1
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6921
Practice Address - Country:US
Practice Address - Phone:865-365-1230
Practice Address - Fax:865-365-1232
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1328235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNSP0000001328OtherSPEECH PATHOLOGIST