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General NPI Number Information
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NPI Number | 1629189972
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Entity Type | Individual
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Provider Name | JANETT DENISE NEEDHAM M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 4017 PRICE RD SUITE 2
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City | BARTLESVILLE
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State | OK
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Zip | 74006-7248
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Country | US
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Telephone | 918-397-1993
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Fax | 918-331-0002
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Provider Business Mailing Address
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Address Line | PO BOX 3333
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City | BARTLESVILLE
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State | OK
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Zip | 74006-3333
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Country | US
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Telephone | 918-397-1993
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Fax | 918-331-0002
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 3175
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License Number State | OK
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