Provider Demographics
NPI:1255979662
Name:GEISNER, JANINE
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:GEISNER
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 1:14010 WEEPING CHERRY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5470
Mailing Address - Country:US
Mailing Address - Phone:301-309-6676
Mailing Address - Fax:
Practice Address - Street 1:1 RESEARCH CT STE 335
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6555
Practice Address - Country:US
Practice Address - Phone:301-996-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist