Provider Demographics
NPI:1043698541
Name:SEGNER, JANINE MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:MARIE
Last Name:SEGNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11410 GREAT MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3608
Mailing Address - Country:US
Mailing Address - Phone:609-972-9110
Mailing Address - Fax:
Practice Address - Street 1:5272 RIVER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-1405
Practice Address - Country:US
Practice Address - Phone:844-906-7846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07822235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist