Provider Demographics
NPI:1053984708
Name:HUNGERFORD, JANEE THORNTON (L/OTR)
Entity type:Individual
Prefix:
First Name:JANEE
Middle Name:THORNTON
Last Name:HUNGERFORD
Suffix:
Gender:F
Credentials:L/OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1264 TEXAS EASTERN RD
Mailing Address - Street 2:
Mailing Address - City:RAGLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70657-7004
Mailing Address - Country:US
Mailing Address - Phone:337-377-9541
Mailing Address - Fax:
Practice Address - Street 1:1264 TEXAS EASTERN RD
Practice Address - Street 2:
Practice Address - City:RAGLEY
Practice Address - State:LA
Practice Address - Zip Code:70657-7004
Practice Address - Country:US
Practice Address - Phone:337-377-9541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310110225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist