Provider Demographics
NPI:1245297191
Name:BROWN, JANETTE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JANETTE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:JANETTE
Other - Middle Name:LANE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:245 SOUTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-8604
Mailing Address - Country:US
Mailing Address - Phone:870-743-4892
Mailing Address - Fax:
Practice Address - Street 1:245 SOUTHGATE DR
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-8604
Practice Address - Country:US
Practice Address - Phone:870-743-4892
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP# 1124235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X412OtherBCBC PROVIDER NUMBER