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General NPI Number Information
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NPI Number | 1831455435
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Entity Type | Individual
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Provider Name | JAMI LYNN HAGAN SLP
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Gender | Female
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 6500 38TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33710-1629
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Country | US
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Telephone | 727-384-1414
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Fax | 727-341-4956
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Provider Business Mailing Address
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Address Line | 3599 UNIVERSITY BOULEVARD SOUTH
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City | JACKSONVILLE
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State | FL
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Zip | 32216
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Country | US
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Telephone | 904-945-7324
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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 | SA5290
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License Number State | FL
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