MEDICARE: MRS. JAIMEE TYSON-MCOMIE 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	SLP-1926	ID

General Provider Information

NPI Number	:	1114316817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JAIMEE TYSON-MCOMIE CCC-SLP

Provider Business Mailing Address
First Line	:	2409 STRATFORD CROSSING DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-6567
Country	:	US
Telephone Number	:	208-965-4921
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 S EXETER ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21202-4365
Country	:	US
Telephone Number	:	877-804-6222
Fax Number	:

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

Provider Enumeration Date	:	01/19/2015
Last Update Date	:	04/03/2024

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Directions to “ MRS. JAIMEE TYSON-MCOMIE CCC-SLP” Practice Location

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