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General NPI Number Information
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NPI Number | 1295348696
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Entity Type | Individual
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Provider Name | JAMISON ANN PIATKA CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 64 COMSTOCK ST
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City | GERMANTOWN
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State | OH
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Zip | 45327-1004
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Country | US
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Telephone | 937-855-4203
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 ANKENEY RD
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City | XENIA
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State | OH
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Zip | 45385-9533
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | COND.20201340-SP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP.14460
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License Number State | OH
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