Provider Demographics
NPI:1891982575
Name:HILL, JAIME (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:
Last Name:HILL
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 1:67 SUNNYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-3662
Mailing Address - Country:US
Mailing Address - Phone:607-759-7846
Mailing Address - Fax:
Practice Address - Street 1:510 5TH AVE
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-1620
Practice Address - Country:US
Practice Address - Phone:607-687-2594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008669235Z00000X
FLSA9579235Z00000X
NY019041235Z00000X
NC7954235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist