Provider Demographics
NPI:1629537279
Name:PRICE, JAIMA SUZANNE (MA, HIS)
Entity Type:Individual
Prefix:MRS
First Name:JAIMA
Middle Name:SUZANNE
Last Name:PRICE
Suffix:
Gender:F
Credentials:MA, HIS
Other - Prefix:MS
Other - First Name:JAIMA
Other - Middle Name:SUZANNE
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:106 EAST WATAUGA AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601
Mailing Address - Country:US
Mailing Address - Phone:423-928-5771
Mailing Address - Fax:423-928-1424
Practice Address - Street 1:106 E WATAUGA AVENUE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601
Practice Address - Country:US
Practice Address - Phone:423-928-5771
Practice Address - Fax:423-928-1424
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN946237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist