MEDICARE: JAMIE WEST FLORIDA M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	108105	TX

General Provider Information

NPI Number	:	1063838944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE WEST FLORIDA M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	1404 ADELL ROSE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043-3613
Country	:	US
Telephone Number	:	713-376-9378
Fax Number	:

Provider Business Practice Location Address
First Line	:	21630 MERCHANTS WAY
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-2514
Country	:	US
Telephone Number	:	832-230-1518
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2014
Last Update Date	:	10/01/2020

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Directions to “ JAMIE WEST FLORIDA M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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