Provider Demographics
NPI:1184284531
Name:ARNOLD, JANNA (BA-SLPA)
Entity type:Individual
Prefix:
First Name:JANNA
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:BA-SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 OAK ST
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180-1923
Mailing Address - Country:US
Mailing Address - Phone:803-546-6927
Mailing Address - Fax:
Practice Address - Street 1:504 CHIMNEY HILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-5402
Practice Address - Country:US
Practice Address - Phone:803-814-3812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6787235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist