MEDICARE: RACHEL LEE JAMERSON 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	114102	TX
2	235Z00000X	Speech-Language Pathologist	3437	OK

General Provider Information

NPI Number	:	1740598929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL LEE JAMERSON M.S.,CCC-SLP

Provider Business Mailing Address
First Line	:	31320 INTERSTATE 10 W STE D
Second Line	:
City	:	BOERNE
State	:	TX
Zip	:	78006-5028
Country	:	US
Telephone Number	:	918-637-9288
Fax Number	:

Provider Business Practice Location Address
First Line	:	8907 ROCKY RDG
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78255-2383
Country	:	US
Telephone Number	:	918-637-9288
Fax Number	:

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

Provider Enumeration Date	:	09/21/2010
Last Update Date	:	11/14/2018

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Directions to “ RACHEL LEE JAMERSON M.S.,CCC-SLP” Practice Location

Language	Start Address	Practice Location

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