Provider Demographics
NPI:1306262613
Name:STANLEY, JANET CARLENE X (MA SLP)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:CARLENE
Last Name:STANLEY
Suffix:X
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 HINES VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-8323
Mailing Address - Country:US
Mailing Address - Phone:865-851-0067
Mailing Address - Fax:
Practice Address - Street 1:101 S MAIN ST
Practice Address - Street 2:SUITE 506
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-3622
Practice Address - Country:US
Practice Address - Phone:865-463-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist