Provider Demographics
NPI:1184103822
Name:DOLPHIN, JANELLE ELLEN
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:ELLEN
Last Name:DOLPHIN
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 1:2501 LOUIS HENNA BLVD APT 518
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-5751
Mailing Address - Country:US
Mailing Address - Phone:512-699-4759
Mailing Address - Fax:512-341-0219
Practice Address - Street 1:2501 LOUIS HENNA BLVD APT 518
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5751
Practice Address - Country:US
Practice Address - Phone:512-699-4759
Practice Address - Fax:512-341-0219
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care