Provider Demographics
NPI:1952314429
Name:WILSON, JAIME NAOMI (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:NAOMI
Last Name:WILSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 DOMINION PARK DR
Mailing Address - Street 2:APT 506
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-6700
Mailing Address - Country:US
Mailing Address - Phone:409-382-9938
Mailing Address - Fax:
Practice Address - Street 1:9810 FM 1960 BYPASS RD W
Practice Address - Street 2:SUITE 190
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3502
Practice Address - Country:US
Practice Address - Phone:281-446-0371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101720235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist