Healthcare Provider Details

I. General information

NPI: 1326216540
Provider Name (Legal Business Name): JANICE WHITTAKER MS, CCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANICE BRIGGS MS, CCC

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 S ORLEANS RD
BREWSTER MA
02631-2870
US

IV. Provider business mailing address

827 RIVERVIEW DR
CHATHAM MA
02633-1120
US

V. Phone/Fax

Practice location:
  • Phone: 508-240-3500
  • Fax: 508-240-1969
Mailing address:
  • Phone: 508-945-0552
  • Fax: 508-348-0221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1530
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: