Provider Demographics
NPI:1578285367
Name:DUPREE, JEWELL SYMONE (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:JEWELL
Middle Name:SYMONE
Last Name:DUPREE
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 STATE ROUTE 3 NORTH
Mailing Address - Street 2:UNIT 201
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054
Mailing Address - Country:US
Mailing Address - Phone:443-808-1218
Mailing Address - Fax:
Practice Address - Street 1:1119 STATE ROUTE 3 NORTH
Practice Address - Street 2:UNIT 201
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054
Practice Address - Country:US
Practice Address - Phone:443-808-1218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02610L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist