Provider Demographics
NPI:1467026112
Name:HOPPER, JANA DANIELLE
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:DANIELLE
Last Name:HOPPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:DANIELLE
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:935 FAIRYSTONE PARK HWY
Mailing Address - Street 2:
Mailing Address - City:STANLEYTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:24168-3014
Mailing Address - Country:US
Mailing Address - Phone:276-622-3636
Mailing Address - Fax:276-627-0060
Practice Address - Street 1:935 FAIRYSTONE PARK HWY
Practice Address - Street 2:
Practice Address - City:STANLEYTOWN
Practice Address - State:VA
Practice Address - Zip Code:24168-3014
Practice Address - Country:US
Practice Address - Phone:276-622-3636
Practice Address - Fax:276-627-0060
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist