Provider Demographics
NPI:1982763157
Name:SHEARER, JANET L (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:L
Last Name:SHEARER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:JANET
Other - Middle Name:L
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:416 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:PORTALES
Mailing Address - State:NM
Mailing Address - Zip Code:88130-9214
Mailing Address - Country:US
Mailing Address - Phone:505-356-6806
Mailing Address - Fax:
Practice Address - Street 1:416 E 17TH ST
Practice Address - Street 2:
Practice Address - City:PORTALES
Practice Address - State:NM
Practice Address - Zip Code:88130-9214
Practice Address - Country:US
Practice Address - Phone:505-356-6806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1115235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist