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General NPI Number Information
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NPI Number | 1508428269
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Entity Type | Individual
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Provider Name | JANELLE RENEE JANAK OTR
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Gender | Female
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 3907A W MARKET ST
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City | GREENSBORO
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State | NC
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Zip | 27407-1303
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Country | US
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Telephone | 336-279-9008
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Fax |
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Provider Business Mailing Address
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Address Line | 7240 GRAYDON DR
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-1453
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 022940
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 022940
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License Number State | NY
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