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NPI Code Detail

MEDICARE: JAMIE CARAWAY SLP,CCC

MEDICARE: JAMIE CARAWAY SLP,CCC
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
1235Z00000XSpeech-Language PathologistSLP006997GA

General Provider Information

NPI Number : 1205128436
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE CARAWAY SLP,CCC
Provider Business Mailing Address
First Line : 3044 DUE WEST RD
Second Line :
City : DALLAS
State : GA
Zip : 30157-2125
Country : US
Telephone Number : 770-443-9672
Fax Number :
Provider Business Practice Location Address
First Line : 3044 DUE WEST RD
Second Line :
City : DALLAS
State : GA
Zip : 30157-2125
Country : US
Telephone Number : 770-443-9672
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2011
Last Update Date : 05/05/2011

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Directions to “ JAMIE CARAWAY SLP,CCC” Practice Location

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