Provider Demographics
NPI:1205053790
Name:HADLY, JANELLE
Entity type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:
Last Name:HADLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 OLYMPIA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9538
Mailing Address - Country:US
Mailing Address - Phone:484-667-8352
Mailing Address - Fax:484-667-8354
Practice Address - Street 1:8 OLYMPIA AVE
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9538
Practice Address - Country:US
Practice Address - Phone:484-667-8352
Practice Address - Fax:484-667-8354
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001056A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer