Jamie Lynn Rabideau, M.A., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Ellenburg, NY
NPI 1740434646 · NPPES record last updated Nov 19, 2019
Key facts
- NPI
- 1740434646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 018169 (NY)
- Practice address
- 5572 Route 11
Ellenburg, NY 12933 - Phone
- (518) 594-7060
- NPI assigned
- Nov 5, 2008
- 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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018169 | NY | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 018169 | NY | Yes |
Addresses
Primary practice location
5572 Route 11
Ellenburg, NY 12933
Mailing address
6806 Route 22
Plattsburgh, NY 12901-4914
Phone (518) 572-5206
Other names
- Jamie Lynn Harrison
Other providers in Ellenburg, NY
All providers in Ellenburg, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2019. 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.