Jamie Vidrine, MCD CCC/SLP
Individual provider Active NPI Speech-Language Pathologist · Washington, LA
NPI 1144624792 · NPPES record last updated Oct 10, 2014
Key facts
- NPI
- 1144624792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 5883 (LA)
- Practice address
- 170 Highway 363
Washington, LA 70589-4501 - Phone
- (337) 849-5448
- NPI assigned
- Oct 10, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5883 | LA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5883 | LA | Yes |
Addresses
Primary practice location
170 Highway 363
Washington, LA 70589-4501
Mailing address
170 Highway 363
Washington, LA 70589-4501
Phone (337) 849-5448
Other providers in Washington, LA
- Crystal Marie Sattler
- Olivia Muller Smith
- Shelly Marie Spaulding
- Tara D Thistlethwaite
- Angelique Vidrine
All providers in Washington, LA · Speech-Language Pathologist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2014. 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.