Healthcare Provider Details

I. General information

NPI: 1457781742
Provider Name (Legal Business Name): JANE ANNE FLOOD SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANE ANNE ENGLISH

II. Dates (important events)

Enumeration Date: 11/22/2013
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 ROBINSON ST
WAKEFIELD RI
02879-3590
US

IV. Provider business mailing address

555 AUBURN ST EASTER SEALS RHODE ISLAND
MANCHESTER NH
03103-4803
US

V. Phone/Fax

Practice location:
  • Phone: 401-284-1000
  • Fax: 401-284-1006
Mailing address:
  • Phone: 401-284-1000
  • Fax: 401-284-1006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP00635
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: