Provider Demographics
NPI:1265647911
Name:JAMISON-CASAS, AMY DEANELLE (MS, CCC, SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:DEANELLE
Last Name:JAMISON-CASAS
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37471 HYDRUS PL
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2781
Mailing Address - Country:US
Mailing Address - Phone:479-883-9890
Mailing Address - Fax:
Practice Address - Street 1:1875 MAIN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-5220
Practice Address - Country:US
Practice Address - Phone:501-819-4028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist