Provider Demographics
NPI:1730327701
Name:PRICE, JANA (MED,SLPCCC)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:MED,SLPCCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 NEAL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-0945
Mailing Address - Country:US
Mailing Address - Phone:931-372-2567
Mailing Address - Fax:
Practice Address - Street 1:1080 NEAL ST STE 300
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-0945
Practice Address - Country:US
Practice Address - Phone:931-372-2567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3988235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist