Provider Demographics
NPI:1184789208
Name:BENNETT, JANET M (MED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 TIMOTHY LN
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9406
Mailing Address - Country:US
Mailing Address - Phone:828-285-8814
Mailing Address - Fax:828-285-9144
Practice Address - Street 1:1063 HAYWOOD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806
Practice Address - Country:US
Practice Address - Phone:828-285-8814
Practice Address - Fax:828-285-9144
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP2308225100000X
NC11663225X00000X
NC596235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7411407Medicaid
14869OtherBLUECROSS BLUESHIELF
C9793OtherMEDCOST