Provider Demographics
NPI:1134489560
Name:CUMMINGS, JOLIE M (MS CCC)
Entity Type:Individual
Prefix:MS
First Name:JOLIE
Middle Name:M
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:
Other - First Name:JOLIE
Other - Middle Name:MINNA
Other - Last Name:EISENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC
Mailing Address - Street 1:150 SANS SOUCI DRIVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6727
Mailing Address - Country:US
Mailing Address - Phone:305-666-1347
Mailing Address - Fax:305-666-4498
Practice Address - Street 1:2625 S.W. 3 AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129
Practice Address - Country:US
Practice Address - Phone:305-854-3282
Practice Address - Fax:305-854-3268
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI1959235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist