Janice Leigh Anne Bennett, M.ED CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Dublin, GA

NPI 1629354568 · NPPES record last updated Aug 14, 2013

Key facts

NPI
1629354568
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP007724 (GA)
Practice address
1205 Bellevue Ave
Suite H
Dublin, GA 31021-4155
Phone
(478) 272-2100
Fax
(478) 272-2005
NPI assigned
Oct 24, 2011
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)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP007724 GA Yes

Addresses

Primary practice location

1205 Bellevue Ave
Suite H
Dublin, GA 31021-4155

Mailing address

1006 Scotland Rd
Rentz, GA 31075-3316
Phone (478) 272-2100

Other identifiers

IdentifierTypeStateIssuer
1770843948OtherGANPI GROUP
003126629AMedicaidGA

Other names

  • Janice Leigh Anne Griggs Former name

Other providers in Dublin, GA

All providers in Dublin, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.