Provider Demographics
NPI:1548005465
Name:GREVIOUS, JANINE
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:GREVIOUS
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 1:106 PORTER ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3116
Mailing Address - Country:US
Mailing Address - Phone:347-894-6780
Mailing Address - Fax:
Practice Address - Street 1:106 PORTER ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-3116
Practice Address - Country:US
Practice Address - Phone:347-894-6780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician