Provider Demographics
NPI:1659680320
Name:HARLAN, JAMIE SHALENE (MS CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:SHALENE
Last Name:HARLAN
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:SHALENE
Other - Last Name:STOGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:30 SW 600TH RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-7545
Mailing Address - Country:US
Mailing Address - Phone:417-814-8992
Mailing Address - Fax:
Practice Address - Street 1:215 S RIDGEVIEW DR
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-2019
Practice Address - Country:US
Practice Address - Phone:660-747-6013
Practice Address - Fax:660-747-3697
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010032529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist