Healthcare Provider Details

I. General information

NPI: 1134648199
Provider Name (Legal Business Name): JAMIE LANCASTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMIE NORTON

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 KURTZ DR
MILFORD MI
48381-2133
US

IV. Provider business mailing address

260 N TIPSICO LAKE RD
HIGHLAND MI
48357-4029
US

V. Phone/Fax

Practice location:
  • Phone: 810-772-1510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number710100433
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: