Provider Demographics
NPI:1659114452
Name:JANNEY, MAGGIE LYNN
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:LYNN
Last Name:JANNEY
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 1:101 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-6605
Mailing Address - Country:US
Mailing Address - Phone:252-289-3997
Mailing Address - Fax:
Practice Address - Street 1:2363 S BRANNON STAND RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-7005
Practice Address - Country:US
Practice Address - Phone:334-618-6809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst