Provider Demographics
NPI:1497202154
Name:MUISE, JASON G (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:G
Last Name:MUISE
Suffix:
Gender:M
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 1:1 BOWDOIN SQ FL 11
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2919
Mailing Address - Country:US
Mailing Address - Phone:617-726-0220
Mailing Address - Fax:
Practice Address - Street 1:1 BOWDOIN SQ FL 11
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2919
Practice Address - Country:US
Practice Address - Phone:617-726-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist