Healthcare Provider Details

I. General information

NPI: 1679723357
Provider Name (Legal Business Name): JAMIE MARIE DOIDGE SCHEPP M.S. SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OLD RT. 23 B
SOUTH CAIRO NY
12482
US

IV. Provider business mailing address

10 ROSEMARYS WAY
LEEDS NY
12451-1654
US

V. Phone/Fax

Practice location:
  • Phone: 518-622-8382
  • Fax:
Mailing address:
  • Phone: 518-821-9144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number015713
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: