Provider Demographics
NPI:1487267993
Name:CALHOUN, JANERIA RACHELLE (ATC)
Entity type:Individual
Prefix:
First Name:JANERIA
Middle Name:RACHELLE
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13665 N 85TH LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4222
Mailing Address - Country:US
Mailing Address - Phone:602-653-5425
Mailing Address - Fax:
Practice Address - Street 1:2820 W ROSE GARDEN LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3134
Practice Address - Country:US
Practice Address - Phone:602-653-5425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZATR-0090422255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer