Provider Demographics
NPI:1558593202
Name:ADAMS, JAYNA ELISE (AUD)
Entity Type:Individual
Prefix:
First Name:JAYNA
Middle Name:ELISE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JAYNA
Other - Middle Name:ELISE
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:3201 S AUSTIN AVE
Mailing Address - Street 2:#370
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7545
Mailing Address - Country:US
Mailing Address - Phone:512-869-0604
Mailing Address - Fax:512-868-5936
Practice Address - Street 1:3201 S AUSTIN AVE
Practice Address - Street 2:#370
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7545
Practice Address - Country:US
Practice Address - Phone:512-869-0604
Practice Address - Fax:512-868-5936
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80261231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist