Jane Mackie Syme

Individual provider Active NPI Speech-Language Pathologist · Ivoryton, CT

NPI 1659836732 · NPPES record last updated Feb 4, 2019

Key facts

NPI
1659836732
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
00612 (CT)
Practice address
65 Main St Unit 29
Ivoryton, CT 06442-1031
Phone
(860) 575-5724
NPI assigned
Feb 4, 2019
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

LicenseStateTypeSpecialty
00612CTMDNaturopath

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 00612 CT Yes

Addresses

Primary practice location

65 Main St Unit 29
Ivoryton, CT 06442-1031

Mailing address

65 Main St Unit 29
Ivoryton, CT 06442-1031
Phone (860) 575-5724

Other providers in Ivoryton, CT

All providers in Ivoryton, CT · Speech-Language Pathologist in Connecticut

Sources for this page

Verify at the official NPI Registry.