Provider Demographics
NPI:1972183697
Name:ADAMS, JANICE ELAINE (EDD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:ELAINE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:MISS
Other - First Name:JANICE
Other - Middle Name:ELAINE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:5482 CHRISTI DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-2502
Mailing Address - Country:US
Mailing Address - Phone:404-883-6458
Mailing Address - Fax:
Practice Address - Street 1:5482 CHRISTI DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-2502
Practice Address - Country:US
Practice Address - Phone:404-883-6458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor