Provider Demographics
NPI:1568267904
Name:PAUL, JANELLE LINETTE
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:LINETTE
Last Name:PAUL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8721 OLD LINE RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2021
Mailing Address - Country:US
Mailing Address - Phone:717-507-1682
Mailing Address - Fax:
Practice Address - Street 1:4819 WALDEN LN # 4880
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4826
Practice Address - Country:US
Practice Address - Phone:240-667-1423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012042235Z00000X
MD11380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist