Jaimie Lynn Manfre, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101005177 Issued in MI

Practice address

46200 Port St
Plymouth, MI 48170-6048

Phone

(734) 454-0866

NPI assigned

Feb 5, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jaimie Lynn Medel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1083179915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37333 BRISTOL ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541763",
            "telephone_number": "734-751-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46200 PORT ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706048",
            "telephone_number": "734-454-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANFRE",
        "first_name": "JAIMIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101005177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIMIE",
            "last_name": "MEDEL",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Naumaan Mallhi, D.O.
• Cashmire Malone
• Allyson Malong
• Vijaya Mamidipaka, M.D.
• Archana Mandhare, NP
• Mangin Psychological Services, LLC
• Stephen Mangin, MS, LLP
• Allison Mann
• Harkirat Mann
• Michael Manno

• Speech-Language Pathologist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.