Provider Demographics
NPI:1154849586
Name:ROCHE, JAMIE ALLISON (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:ALLISON
Last Name:ROCHE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 PHILO RD
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14903-1051
Mailing Address - Country:US
Mailing Address - Phone:607-739-3581
Mailing Address - Fax:607-795-5304
Practice Address - Street 1:1126 BALD HILL RD
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-1262
Practice Address - Country:US
Practice Address - Phone:607-324-7880
Practice Address - Fax:607-795-5304
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026768235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist