Jamie Renee Cole, M.S., SLP-CCC
Individual provider Active NPI Speech-Language Pathologist · Mount Vernon, IL
NPI 1053435313 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053435313
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 15678 E Blackward LN
Mount Vernon, IL 62864-8651 - Phone
- (618) 242-4582
- Fax
- (618) 242-4582
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.008569 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | IL | Yes |
Addresses
Primary practice location
15678 E Blackward LN
Mount Vernon, IL 62864-8651
Mailing address
15678 E Blackward LN
Mount Vernon, IL 62864-8651
Phone (618) 242-4582
Other providers in Mount Vernon, IL
- Koletta Rae Clarke
- Clarkson Optometry Illinois PC
- Keith Alan Cloe
- Paula Clouse
- Ashlie Cole
- Andre A Coleman
- Michelle Collier
- Kim Ann Collins
- Jamie Josephine Compton
- Vincent Coty Compton
All providers in Mount Vernon, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.