Provider Demographics
NPI:1083057533
Name:GODSEY-NEUBERT, JAMIE KATHRYN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:KATHRYN
Last Name:GODSEY-NEUBERT
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4614 GINGER CT
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-4565
Mailing Address - Country:US
Mailing Address - Phone:720-272-5066
Mailing Address - Fax:
Practice Address - Street 1:2210 LELARAY ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2220
Practice Address - Country:US
Practice Address - Phone:719-475-0477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist