Provider Demographics
NPI:1679889695
Name:CHESSON, JANICE G (BS, MA)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:G
Last Name:CHESSON
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 GRANVILLE DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-9800
Mailing Address - Country:US
Mailing Address - Phone:252-946-6419
Mailing Address - Fax:
Practice Address - Street 1:6118 HIGHWAY 264
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-9800
Practice Address - Country:US
Practice Address - Phone:252-944-5393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNO. 403235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist