Mary Janus, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · St Simons Is, GA
NPI 1376844837 · NPPES record last updated Nov 15, 2010
Key facts
- NPI
- 1376844837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP002066 (GA)
- Practice address
- 402 Magnolia St
St Simons Is, GA 31522-1348 - Phone
- (912) 634-0887
- NPI assigned
- Nov 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP002066 | GA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP002066 | GA | Yes |
Addresses
Primary practice location
402 Magnolia St
St Simons Is, GA 31522-1348
Mailing address
402 Magnolia St
St Simons Is, GA 31522-1348
Phone (912) 634-0887
Other providers in St Simons Is, GA
- Ronald Tracy Gerken
- Matthew Mackinnon Gibbs
- Gail Katherine Godwin
- Karen Heller Griffith
- Stephanie Griggs
- Kari E. Kizzire
- Trinity Martin
- Michaelene McGinnis
- Elizabeth Morris
- Tony Nguyen
All providers in St Simons Is, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.