Provider Demographics
NPI:1689006108
Name:FINCH-DERRO, JAMI LYNNE
Entity Type:Individual
Prefix:MRS
First Name:JAMI
Middle Name:LYNNE
Last Name:FINCH-DERRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 ANDOVER LN
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-2965
Mailing Address - Country:US
Mailing Address - Phone:847-354-3334
Mailing Address - Fax:
Practice Address - Street 1:1799 ANDOVER LN
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-2965
Practice Address - Country:US
Practice Address - Phone:847-354-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006218235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist