Provider Demographics
NPI:1407077399
Name:JAMIESON, SHAUNA
Entity Type:Individual
Prefix:MS
First Name:SHAUNA
Middle Name:
Last Name:JAMIESON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364-1510
Mailing Address - Country:US
Mailing Address - Phone:207-242-0020
Mailing Address - Fax:
Practice Address - Street 1:15 HASSON ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:ME
Practice Address - Zip Code:04344-1613
Practice Address - Country:US
Practice Address - Phone:207-242-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist