Provider Demographics
NPI:1184449852
Name:CHILES, JAMIE LEIGH (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:JAMIE LEIGH
Middle Name:
Last Name:CHILES
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 1:154 REA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5522
Mailing Address - Country:US
Mailing Address - Phone:978-837-1019
Mailing Address - Fax:
Practice Address - Street 1:1 MERRILL ST UNIT 13
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MA
Practice Address - Zip Code:01952-2307
Practice Address - Country:US
Practice Address - Phone:603-918-1298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP100500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist