Provider Demographics
NPI:1740598929
Name:JAMERSON, RACHEL LEE (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEE
Last Name:JAMERSON
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31320 INTERSTATE 10 W STE D
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-5028
Mailing Address - Country:US
Mailing Address - Phone:918-637-9288
Mailing Address - Fax:
Practice Address - Street 1:8907 ROCKY RDG
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78255-2383
Practice Address - Country:US
Practice Address - Phone:918-637-9288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114102235Z00000X
OK3437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist