Provider Demographics
NPI:1528237138
Name:GREGSON, JANA
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:GREGSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N ROCKINGCHAIR RD
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-2414
Mailing Address - Country:US
Mailing Address - Phone:870-897-2372
Mailing Address - Fax:870-236-2529
Practice Address - Street 1:107 N ROCKINGCHAIR RD
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-2414
Practice Address - Country:US
Practice Address - Phone:870-897-2372
Practice Address - Fax:870-236-2529
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P8409235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist