Provider Demographics
NPI:1992103147
Name:OSBORNE REID, JANEY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:JANEY
Middle Name:
Last Name:OSBORNE REID
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37605-0191
Mailing Address - Country:US
Mailing Address - Phone:240-446-6323
Mailing Address - Fax:423-328-8662
Practice Address - Street 1:1319 SUNSET DR STE 102
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-7907
Practice Address - Country:US
Practice Address - Phone:240-446-6323
Practice Address - Fax:423-328-8662
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist